Frequency of Hypomagnesemia and Its Correlation with Cardiac Biomarkers in Patients with Acute Coronary Syndrome

Abstract

Objectives: This study aimed to assess the frequency of hypomagnesemia among patients presenting with acute coronary syndrome (ACS) and to evaluate its correlation with biochemical markers of cardiac injury—specifically Troponin-I (Trop-I), Creatine Kinase-MB (CK-MB), and Brain Natriuretic Peptide (BNP)—as well as associated clinical outcomes. Methodology: A total of 185 patients diagnosed with ACS were enrolled. Serum magnesium levels were measured within 24 hours of hospital admission. Hypomagnesemia was defined as serum magnesium <1.7 mg/dL. Cardiac biomarkers (Trop-I, CK-MB, BNP) were assessed on admission and monitored during hospitalization. Clinical outcomes including in-hospital mortality, arrhythmias, heart failure, recurrent ischemia, and other complications were recorded and analyzed. Results: Hypomagnesemia was detected in 60 of the 185 patients (32.4%). Patients with hypomagnesemia exhibited significantly higher levels of Trop-I, CK-MB, and BNP compared to those with normal magnesium levels (p < 0.05). Hypomagnesemia was also associated with significantly higher rates of mortality (20% vs. 6.4%, p = 0.05), heart failure (41.7% vs. 28%, p = 0.04), recurrent ischemia (16.7% vs. 4%, p = 0.03), and other complications (25% vs. 8%, p = 0.04). No significant difference was observed in the incidence of arrhythmias between the two groups (p = 0.32). Conclusion: Hypomagnesemia is commonly observed in ACS patients and is significantly associated with elevated cardiac biomarkers and worse clinical outcomes, including increased mortality and complications. These findings suggest that magnesium deficiency may exacerbate myocardial injury and negatively impact prognosis in ACS. Magnesium supplementation presents a potential therapeutic intervention and warrants further investigation in larger, controlled studies.

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Pakistan Heart Journal; Vol. 58 No. 2 (2025), pp. 183-189

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