Hypermagnesemia predicts mortality in elderly with congestive heart disease: Relationship with laxative and antacid use
Hypermagnesemia predicts mortality in elderly with congestive heart disease: Relationship with laxative and antacid use
复制标题
DOI：
10.1089/rej.2007.0583
复制
发表时间：
2008-02-01
影响因子：
2.6
通讯作者：
Ferrara, Nicola
中科院分区：
文献类型：
--
作者：
Corbi, Graziamaria;Acanfora, Domenico;Ferrara, Nicola
本研究的目的是评估镁水平对入住泰莱塞/坎波利 S. Maugeri 基金会科学研究所康复心脏病科的 WHO 充血性心力衰竭老年人 3 年生存率的影响。所有老年患者：65岁诊断为CHF的患者均接受临床和仪器检查，记录其人口统计学、合并症、院内死亡率和3年死亡率。 4.8% 的受试者出现低镁血症，67.5% 的受试者出现正常镁血症，27.8% 的受试者出现高镁血症。低镁血症组因人数不足而被排除；该分析总共对 199 名老年患者进行。高镁血症占 29.1%，正常镁血症占 70.9%。在单变量分析中，与正常镁血症组相比，高镁血症没有发现差异，除了肌酐血症水平稍高（分别为 1.35 +/- 0.61 与 1.13 +/- 0.55 mg/dL；p < 0.02）、更大的残疾（丧失 ADL，分别为 2.69 +/- 1.57 与 2.15 +/- 1.56；p < 0.05），CHF 死亡率更高（32.6% vs. 48.3%；p < 0.05），抗酸剂和泻药的使用率更高（分别为 82.7% vs. 24.8%；p < 0.0001）。镁含量较高的患者在 3 年随访中的生存概率低于镁含量较低的患者（17.32 +/- 15.93 与 22.46 +/- 16.16 个月；p < 0.05），并且在调整一些混杂因素后，这一发现在多变量分析中仍然显着。最后，在没有预先存在肾功能衰竭临床证据的情况下，也应考虑高镁血症，因为它具有负面的预后价值，特别是对于患有 CHF 的老年患者。高镁血症与泻药/抗酸剂使用之间的关系应促使医生更加关注这些药物的滥用。
The aim of this study was to evaluate the role of magnesium levels on 3-year survival in the elderly with congestive heart failure WHO admitted to the Rehabilitative Cardiology Unit of S. Maugeri Foundation Scientific Institute of Telese/Campoli. All elderly patients : 65 years old with a diagnosis of CHF underwent clinical and instrumental examination, and their demographics, co-morbidity, and in-hospital and 3-year mortality rates were recorded. Hypo-magnesernia was found in 4.8%, normomagnesemia in 67.5%, and hypermagnesemia in 27.8% of subjects. The hypomagnesemic group was excluded for numerical exiguity; the analysis was performed on a total of 199 elderly patients. Hypermagnesemia was found in 29.1% and normomagnesemia in 70.9%. At the univariate analysis no differences were found in hypermagnesemia in respect to normomagnesemia group, except for slightly higher levels of creatininemia (1.35 +/- 0.61 vs. 1.13 +/- 0.55 mg/dL, respectively; p < 0.02), greater disability (lost ADL, 2.69 +/- 1.57 vs. 2.15 +/- 1.56, respectively; p < 0.05), more mortality for CHF (32.6 vs. 48.3%; p < 0.05), and higher antacid and laxative use (82.7 vs. 24.8%, respectively; p < 0.0001). Patients with higher magnesium showed less probability to survive at a 3-year follow-up than did patients with lower levels (17.32 +/- 15.93 vs. 22.46 +/- 16.16 months; p < 0.05), and this finding remained significant in the multivariate analysis after adjusting for some confounders. Finally hypermagnesemia should also be considered in the absence of pre-existing renal failure clinical evidence because of its negative prognostic value, especially in elderly patients with CHF. The shown relationship between hypermagnesemia and laxative/antacid use should induce physicians to pay more attention to abuse of these drugs.