title: The Importance of Magnesium Values in Patients With STEMI Admitted to the Emergency Department.
abstract: OBJECTIVE
  The aim of this study is to examine the relationship between initial magnesium (Mg) levels, electrocardiographic no-reflow, and long-term mortality in patients who underwent primary percutaneous coronary intervention (pPCI) due to ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  A total of 111 patients with pPCI participated in the study. Magnesium and high-sensitive C-reactive protein (hs-CRP) were measured. The sum of ST-segment elevation was measured immediately before and 60 minutes after the restoration of coronary flow. The difference between the 2 measurements was taken as the amount of ST-segment resolution and defined as sum of ST-segment resolution (∑STR). The ∑STR <50% was determined as electrocardiographic sign of no-reflow phenomenon. After the patients were discharged, they were followed up for major adverse cardiac events for up to 51 months after discharge.
  
  
  RESULTS
  Forty patients in the no-reflow group and 71 patients in the normal-flow group were included in the study. Magnesium value ≤1.87 mg/dL initially measured had 77% sensitivity and 59% specificity in predicting no-reflow on receiver operating characteristic curve analysis. In multivariate analyses, Mg (odds ratio [OR]: 0.01, <95% confidence interval [CI]: 0.01-0.12; P = .004), hs-CRP (OR: 1.06, <95% CI: 1.00-1.14; P = .05), left anterior descending artery lesion (OR: 6.66, <95% CI: 1.45-3.05; P = .01), and reperfusion time (OR: 1.01, <95% CI: 1.00-1.01; P = .03) were still independent predictors of electrocardiographic no-reflow, and only Mg (OR: 0.08, <95% CI: 0.01-1.03; P = .05) was still an independent predictor of long-term mortality.
  
  
  CONCLUSIONS
  Serum Mg level is an independent predictor of electrocardiographic no-reflow and long-term mortality in patients with STEMI.
authors.affiliation: 1 Department of Emergency Medicine, School of Medicine, Balikesir University, Balikesir, Turkey.
authors.forename: Melih
authors.initials: M
authors.lastname: Yuksel
authors.affiliation: 2 Department of Cardiology, School of Medicine, Balikesir University, Balikesir, Turkey.
authors.forename: Turgay
authors.initials: T
authors.lastname: Isik
authors.affiliation: 3 Department of Cardiology, School of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Ibrahim Halil
authors.initials: IH
authors.lastname: Tanboga
authors.affiliation: 2 Department of Cardiology, School of Medicine, Balikesir University, Balikesir, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Ayhan
authors.affiliation: 1 Department of Emergency Medicine, School of Medicine, Balikesir University, Balikesir, Turkey.
authors.forename: Mehmet Emre
authors.initials: ME
authors.lastname: Erimsah
authors.affiliation: 3 Department of Cardiology, School of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Topcu
authors.affiliation: 4 Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey.
authors.forename: Selami
authors.initials: S
authors.lastname: Demirelli
authors.affiliation: 3 Department of Cardiology, School of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Enbiya
authors.initials: E
authors.lastname: Aksakal
authors.affiliation: 3 Department of Cardiology, School of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Sevimli
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism*; D004562:Electrocardiography / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008274:Magnesium / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D054318:No-Reflow Phenomenon / Q000097:blood*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein; D008274:Magnesium
keywords: ST-segment elevation myocardial infarction; electrocardiographic no-reflow; magnesium; primary percutaneous coronary intervention