Low Serum Magnesium as a Predictive Factor of Major Adverse Cardiac and Cerebrovascular Events in Maintenance Hemodialysis Patients

Abstract

Abstract Introduction: Major adverse cardiac and cerebrovascular events are the major complication and leading cause of maintenance hemodialysis (MHD) patients. This study was aimed to assess the relationship between serum magnesium (Mg) and major adverse cardiac and cerebrovascular events (MACCE) in MHD patients. Methods: 290 patients were enrolled in the prospective cohort study, which were divided into three categories according to the concentration of serum Mg (LMg, MMg, and HMg), with a 60-month flowing-up. Kaplan-Meier analysis, univariate and multivariate Cox proportional hazards models were introduced to evaluate the role of serum Mg, and the potential prognostic values of the adjusted models were assessed with the time-dependent ROC curve. Results: During the follow-up period, a total of 69 patients experienced MACCE, including 35 cases of cardiovascular mortality, 22 cases of acute heart failure, and 12 cases of cerebrovascular events. Kaplan-Meier analysis showed that the incidence of MACCE (Log-Rank = 0.017) was significantly higher in patients with relatively low levels of Mg. The univariate Cox proportional hazard model indicated the low level of serum Mg was significantly pertinent to MACCE (LMg, HR 2.40, 95% CI 1.26-4.56; MMg, HR 2.13, 95% CI 1.12-4.07). After being adjusted for confounding factors, it was valid in models 1-9. Further subgroup analyses indicated that the risky role of low magnesium in the occurrence of cardiovascular mortality (HR 2.67, 95% CI 1.16-6.15). Conclusions: Low serum Mg was correlated with higher MACCE risks in MHD patients.