Background: Although magnesium (Mg) has been proposed as a useful biomarker for predicting atherothrombosis, the association between Mg and acute stent thrombosis (ST) after primary percutaneous coronary intervention (p-PCI) for ST-segment elevation myocardial infarction (STEMI) has not yet been defined.
Objectives: We aimed to examine whether admission Mg levels predicted the development of acute ST after p-PCI in STEMI patients.
Methods and results: A total of 2633 patients with STEMI who underwent p-PCI were retrospectively analyzed. Acute ST was defined as thrombosis that occurred in the first (0-1) days following primary coronary stenting, and patients who had undergone p-PCI were divided into two groups: ST group and no-ST group. The cut-off value for Mg obtained by the receiver-operating characteristic curve analysis was less than 1.91 mg/dl for the prediction of acute ST (area under the curve was 0.761; 95% confidence interval, 0.706-0.816; P<0.001; sensitivity, 70%; specificity, 69%). Serum Mg levels were significantly lower in the ST group compared with the no-ST group (median 1.80 mg/dl, interquartile range 1.70-2.00 mg/l vs. median 2.10 mg/dl, interquartile range 1.90-2.20 mg/dl, P<0.001). After multivariable adjustment for clinical, laboratory, and angiographic variables, Mg remained a strong independent predictor for acute ST (odds ratio 5.802, 95% confidence interval, 3.069-10.967; P<0.001).
Conclusion: Serum Mg level is associated independently with the risk of acute ST in patients with STEMI who undergo p-PCI.