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Association of Serum Magnesium and Calcium - Magnesium Ratio with Mortality in Patients with Coronary Artery Disease (P18-090-19).

Objectives
Low serum magnesium (Mg) and high serum calcium (Ca) levels have been linked to increased mortality and cardiovascular disease (CVD) in the general population. This prospective study assessed whether there were independent associations of serum Mg levels and Ca-Mg ratio with all-cause and CVD mortality among patients with coronary artery disease (CAD).


Methods
A prospective cohort study of 3380 CAD patients was conducted. Cox regression models were used to estimate the association of serum Mg levels and Ca-Mg ratio with the risk of mortality.


Results
During a median follow-up of 7.59 years, there were 562 deaths recorded and 331 of them were CVD deaths. Spline plots displayed U-shaped associations between serum Mg levels and Ca-Mg ratio and all-cause as well as CVD mortality among CAD patients. Patients in the low serum Mg group had a 1.63-fold (95% confidence interval [CI] 1.32-2.00) risk of all-cause mortality and a 1.82-fold (95% CI 1.40-2.36) risk of CVD mortality compared with those in medium serum Mg group. Patients in high Ca-Mg ratio group had a 1.30-fold (95% CI 1.05-1.61) risk of all-cause mortality and a 1.50-fold (95% CI 1.13-1.98) risk of CVD mortality compared with those in medium Ca-Mg group. This inverse association between serum Mg and the risk of mortality did not change when participants were stratified by sex, age, types of CHD, history of diabetes and estimated glomerular filtration rate.


Conclusions
Low serum Mg concentrations and high Ca-Mg ratio were significantly associated with an increased risk of all-cause and CVD mortality in Chinese patients with CAD, independent of traditional CVD risk factors.


Funding Sources
The National Natural Science Fund.