Association between Low Serum Magnesium Level and Major Adverse Cardiac Events in Patients Treated with Drug-Eluting Stents for Acute Myocardial Infarction

Background: Acute Myocardial Infarction is the leading cause of morbidity and mortality throughout the world. Its prevalence among developing countries has increased significantly over the past two decades. Acute myocardial infarction is associated with electrolyte imbalance most commonly hypomagnesemia and hypokalaemia. Both are associated with ventricular arrhythmia which can lead to increase hospital mortality and morbidity. Objectives: To find out association of hypomagnesemia with ventricular arrhythmia in patients with acute myocardial infarction. Methods: Patients with acute myocardial infarction admitted in the department of Cardiology, DMCH, within the study period and who fulfilled the inclusion and exclusion criteria were taken as study sample. Informed consent was taken from all patients and then the patients were evaluated by detailed history, clinical examination and relevant investigations. Serum magnesium level was measured after admission. The sample population was Grouped into Group A(Acute myocardial infarction with normal serum magnesium) and Group B(Acute myocardial infarction with hypomagnesemia). Patients were followed up regularly till discharge or death for evidence of ventricular arrhythmia. Then the obtained data was analysed with SPSS 22.0. Results: Among 110 patients of Acute MI, 44 patients were in Group A who had plasma magnesium level e”0.7 mmol/ l and 66 patients were in Group B who had plasma magnesium level <0.7 mmol/l. Incidence of hypoagnesemia was 60% and more common in male. Male vs female percentage of hypomagnesemia were 61% vs 39%. Mean age was 54.16±11.72 yrs vs 57.52±10.59 yrs in group A vs group B. On admission serum magnesium level was 0.9218 vs 0.523 mmol/L( group A vs group B). The study showed that group B patients were more haemodynamically unstable and mean SBP and DBP were found 89.39±19.93 and 60.67±11.56 mm-Hg respectively. Troponin I was markedly increased in group B than A (i.e 4.7±1.79 vs 14.6±4.3 vs ng/ml). Adverse cardiac events such as cardiogenic shock (group A vs group B = 11.36% vs 28.27%) and ventricular arrhythmias(group A vs group B = 34% vs 72.73%) were also higher in group B than group A. Mean hospital stay for group B patient was higher than group A(6.78±0.85 vs 5.31±0.35 days). The study result showed that ventricular arrhythmia is negatively correlated with serum magnesium and the correlation coefficient was - 0.541. It also showed that serum Magnesium is positively correlated with Potassium(r= 0.831, p<0.01) and Calcium(r= 0.902, p<0.001). Multiple logistic regression analysis showed that hypomagnesemia is an independent risk factor for ventricular arrhythmia. Conclusions: This study showed that in patients with acute myocardial infarction, hypomagnesemia is common and it is significantly associated with ventricular arrhythmia. So the presence of hypomagnesemia should alert the physicians to adopt corrective measures as it increases both mortality and morbidity. Bangladesh Heart Journal 2020; 35(1) : 39-46

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Outcomes of Acute Myocardial Infarction Patients Implanted With Biodegradable Polymer Biolimus-Eluting Stents Versus New-Generation Durable Polymer Drug-Eluting Stents: A Retrospective Analysis

Angiology ◽

10.1177/0003319716679339 ◽

2016 ◽

Vol 68 (8) ◽

pp. 698-706

Author(s):

Jeong Cheon Choe ◽

Kwang Soo Cha ◽

Hye Yoon Jang ◽

Jong Hyun Choi ◽

Bo Won Kim ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Stent Thrombosis ◽

Biodegradable Polymer ◽

Cardiac Events ◽

Durable Polymer ◽

Adverse Cardiac Events ◽

Acute Mi ◽

Drug Eluting ◽

New Generation

We compared outcomes between biodegradable polymer biolimus-eluting stent (BP-BES) and new-generation durable polymer drug-eluting stent (DP-DES) implantations in patients with acute myocardial infarction (MI). Among 13472 patients with acute MI in a nationwide registry, 557 (64.8%) were in the BP-BES and 303 (35.2%) in the new-generation DP-DES group following coronary reperfusion. The occurrence of major adverse cardiac events (MACE; death, MI, revascularization) and stent thrombosis was compared. Major adverse cardiac events occurred in 53 (6.2%) patients and showed similar rates between the BP-BES and new-generation DP-DES groups (all: 6.6% vs 5.9%, P = .652; propensity score [PS] matched: n = 380, 6.3% vs 5.3%, P = .623). Stent thrombosis did not differ between groups (all: 0.3% vs 0.4%, P = .892; PS matched: 0.5% vs 0.5%, P = 1.000). Major adverse cardiac event-free survival was comparable between groups (all: 93.4% vs 94.1%, log-rank P = .357; PS matched: 93.7% vs 94.7%, log-rank P = .445). Biodegradable polymer biolimus-eluting stent was not associated with MACE (all: hazard ratio [HR], 1.67; 95% confidence interval [CI], 0.75-3.74; P = 0.212; PS matched: HR, 1.05; 95% CI, 0.40-2.75; P = .915). In conclusion, in patients with acute MI, BP-BES was equivalent to the new-generation DP-DES in terms of outcomes.

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Real-World Three-Year Clinical Outcomes of Biolimus-Eluting Stents versus Other Contemporary Drug-Eluting Stents in Patients with Acute Myocardial Infarction Patients: Data from the Korea Acute Myocardial Infarction Registry (KAMIR)

Journal of Interventional Cardiology ◽

10.1155/2021/6698582 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Ji Young Park ◽

Seung-Woon Rha ◽

Yung-Kyun Noh ◽

Byoung Geol Choi ◽

Ji Yeon Hong ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiac Death ◽

Bare Metal Stents ◽

Target Lesion ◽

Drug Eluting Stents ◽

Metal Stents ◽

Cardiac Events ◽

Total Death ◽

Drug Eluting

Introduction. Biolimus-eluting stents (BES) are known to be superior to bare-metal stents. This study aims to evaluate the safety and efficacy of BES compared to other drug-eluting stents (DES) based on big data from the Korea Acute Myocardial Infarction Registry (KAMIR). Methods. The study analyzed a total of 9,759 acute myocardial infarction (AMI) patients who underwent percutaneous coronary intervention (PCI) with DES. Total death, cardiac death, recurrent MI, revascularization, stent thrombosis, target lesion failure (TLF, composite of cardiac death, recurrent myocardial infarction (MI), and target lesion revascularization), and major adverse cardiac events (MACE, composite of total death, recurrent MI, and revascularization) were analyzed in patients with AMI up to three years. Study populations were divided into BES (n = 2,020), everolimus-eluting stents (EES, n = 5,293), and zotarolimus-eluting stents (ZES, n = 2,446) groups. Results. To adjust baseline potential confounders, an inverse probability weighting (IPTW) analysis was performed. After IPTW, at three years, total death (7.2%, 8.6%, and 9.5%, P < 0.001 ), cardiac death (4.1%, 5.3%, and 6.6%, P < 0.001 ), recurrent MI (1.6%, 2.6%, and 3.2%, P < 0.001 ), TLF (6.5%, 8.1%, and 9.1%, P < 0.001 ), and MACE (15.8%, 17.5%, and 18.2%, P < 0.001 ) were lowest in the BES group compared with the other DES groups in AMI patients. During the 3-year clinical follow-up, the BES group showed better outcomes of MACE (hazard ratio (HR), 0.773; 95% confidence interval (CI), 0.676–0.884; P < 0.001 ), TLF (HR, 0.659; 95% CI, 0.538–0.808; P < 0.001 ), total death (HR, 0.687; 95% CI, 0.566–0.835; P < 0.001 ), and cardiac death (HR,0.593; 95% CI, 0.462–0.541; P < 0.001 ) than the EES groups. Conclusions. In this study, BES was superior to EES or ZES in reducing total death, cardiac death, TLF, and MACE in AMI patients.

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Serum magnesium level and QTc interval prolongation in acute myocardial infarction patients and its correlation with arrhythmias

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194584 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4015

Author(s):

Laxmi Mohanani ◽

Kuldeep Deopujari ◽

Rangvendra Singh Meena ◽

T. N. Dubey

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Serum Magnesium ◽

Myocardial Cell ◽

Magnesium Level ◽

Qtc Interval ◽

Serum Magnesium Level ◽

Interval Prolongation ◽

Low Magnesium ◽

Qtc Interval Prolongation

Background: Arrhythmias commonly occur early in acute myocardial infarction and remain a common cause of sudden death in AMI. Magnesium has been implicated in the pathogenesis of acute myocardial infarction and its complication like arrhythmia. Magnesium improves myocardial metabolism, inhibits calcium accumulation and myocardial cell death. It improves vascular tone, peripheral vascular resistance, after load and cardiac output and reduces cardiac arrhythmias. The objective of this study to investigate the serum magnesium level and QTc interval prolongation in AMI and its correlation with arrhythmias.Methods: In this study, 200 patients of AMI were enrolled. ECG and cardiac parameters were examined. Serum magnesium level is measured and the QTc interval was calculated.Results: MI was more prevalent in the male patients (63.3%) and age group of 41-50 years. Hypertension (35.7%), smoking (34.2%), and diabetes (23.1%) were the major risk factor for MI. Mean serum magnesium level was 1.64±0.37 among those having arrhythmia that is significantly low as compared to those having no arrhythmia among which mean serum magnesium level was 2.28±0.31 (p<0.001). Mean QTc was higher (546.88 ms vs. 404.33ms) in patients documented with arrhythmia compared with those who had no arrhythmia (p<0.001).Conclusions: In acute myocardial infarction, patients with low magnesium levels and prolonged QTc interval are more prone to get arrhythmias. So magnesium treatment can be considered in patients of acute myocardial infarction with low magnesium levels.

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“Serum Magnesium Level in Acute Myocardial Infarction: A Study in Rajshahi Medical College Hospital, Rajshahi, Bangladesh”

Saudi Journal of Medical and Pharmaceutical Sciences ◽

10.36348/sjmps.2020.v06i01.020 ◽

2020 ◽

Vol 06 (01) ◽

pp. 133-142

Author(s):

Md. Abdul Baset ◽

Md. Zahirul Haque ◽

Md. Azizul Hoque ◽

Shabyasachi Nath ◽

Shah Mohammad Hassanur Rahman

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Serum Magnesium ◽

Magnesium Level ◽

Medical College Hospital ◽

Serum Magnesium Level ◽

College Hospital ◽

Medical College

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Admission Serum Magnesium Level Does Not Predict the Hospital Outcome of Patients With Acute Myocardial Infarction

Archives of Internal Medicine ◽

10.1001/archinte.1996.00440140135013 ◽

1996 ◽

Vol 156 (15) ◽

pp. 1701 ◽

Cited By ~ 1

Author(s):

John E. Madias

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Serum Magnesium ◽

Magnesium Level ◽

Serum Magnesium Level ◽

Hospital Outcome

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Pericoronary fat inflammation and Major Adverse Cardiac Events (MACE) in prediabetic patients with acute myocardial infarction: effects of metformin

Cardiovascular Diabetology ◽

10.1186/s12933-019-0931-0 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 16

Author(s):

Celestino Sardu ◽

Nunzia D’Onofrio ◽

Michele Torella ◽

Michele Portoghese ◽

Francesco Loreni ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Adipose Tissue ◽

Artery Bypass ◽

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Metformin Therapy ◽

Adverse Cardiac Events ◽

Factor Α

Abstract Background/objectives Pericoronary adipose tissue inflammation might lead to the development and destabilization of coronary plaques in prediabetic patients. Here, we evaluated inflammation and leptin to adiponectin ratio in pericoronary fat from patients subjected to coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI). Furthermore, we compared the 12-month prognosis of prediabetic patients compared to normoglycemic patients (NG). Finally, the effect of metformin therapy on pericoronary fat inflammation and 12-months prognosis in AMI-prediabetic patients was also evaluated. Methods An observational prospective study was conducted on patients with first AMI referred for CABG. Participants were divided in prediabetic and NG-patients. Prediabetic patients were divided in two groups; never-metformin-users and current-metformin-users receiving metformin therapy for almost 6 months before CABG. During the by-pass procedure on epicardial coronary portion, the pericoronary fat was removed from the surrounding stenosis area. The primary endpoints were the assessments of Major-Adverse-Cardiac-Events (MACE) at 12-month follow-up. Moreover, inflammatory tone was evaluated by measuring pericoronary fat levels of tumor necrosis factor-α (TNF-α), sirtuin 6 (SIRT6), and leptin to adiponectin ratio. Finally, inflammatory tone was correlated to the MACE during the 12-months follow-up. Results The MACE was 9.1% in all prediabetic patients and 3% in NG-patients. In prediabetic patients, current-metformin-users presented a significantly lower rate of MACE compared to prediabetic patients never-metformin-users. In addition, prediabetic patients showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to NG-patients (P < 0.001). Prediabetic never-metformin-users showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to current-metformin-users (P < 0.001). Remarkably, inflammatory tone and leptin to adiponectin ratio was significantly related to the MACE during the 12-months follow-up. Conclusion Prediabetes increase inflammatory burden in pericoronary adipose tissue. Metformin by reducing inflammatory tone and leptin to adiponectin ratio in pericoronary fat may improve prognosis in prediabetic patients with AMI. Trial registration Clinical Trial NCT03360981, Retrospectively Registered 7 January 2018

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