Abstract

Background: Serum magnesium (Mg) has been reported to be inversely associated with the risk of atrial fibrillation (AF), coronary artery disease (CAD), and major adverse cardiovascular events (MACE). However, whether high serum Mg is associated with a lower risk of MACE, heart failure (HF), stroke, and all-cause mortality among AF patients remains unclear. Methods: We evaluated prospectively 503 participants of the Atherosclerosis Risk in Communities (ARIC) Study with available serum Mg and a diagnosis of AF at the time of Mg measurement participating in visit 2 (1990-1992, n = 90) or visit 5 (2011-2013, n = 403). Serum Mg was modeled in tertiles and as a continuous variable in standard deviation units. Endpoints (HF, MI, stroke, cardiovascular (CV) death, all-cause mortality, and MACE) were identified and modeled separately using Cox proportional hazard regression adjusting for potential confounders. Results: During a mean follow-up of 7.0 years, there were 105 HF, 50 MI, 36 stroke, 119 CV deaths, 160 total deaths, and 285 MACE. After adjustment for demographic and clinical variables, participants in the 2 nd and 3 rd tertiles of serum Mg had lower rates of most endpoints, with the strongest inverse association for the incidence of MI (Table). Serum Mg modeled linearly as a continuous variable did not show clear associations with endpoints. Due to limited number of events, precision of most estimates of association was relatively low. Conclusion: Higher serum Mg was associated with lower risk of developing incident MI and, to a lesser extent, other cardiovascular endpoints. Further studies in larger AF patient cohorts are needed to evaluate the role of serum Mg in preventing adverse CV outcomes in these patients.

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