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Circulating magnesium as a potential risk stratification tool for sudden cardiac death: a systematic review

Zirkulierendes Magnesium als potenzieller Risikostratifizierungsparameter für den plötzlichen Herztod – eine systematische Übersicht

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Abstract

Background

Sudden cardiac death (SCD) is one of the main causes of cardiovascular mortality and accounts for 15–20% of deaths worldwide. The current stratification strategy using depressed left ventricular ejection fraction is insufficient to stratify the risk of SCD, especially in the general population. In recent years, there has been increasing evidence showing the antiarrhythmic properties of magnesium. In this systematic review, the authors aim to determine circulating magnesium as a potential risk stratification tool for SCD.

Methods

This systematic review was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was conducted in July 2021 with sources from Google Scholar, PubMed, Science Direct, EBSCO Medline, and ProQuest.

Results

A total of six studies were included in this review. Three studies conducted in the general population consistently showed lower risk of SCD in populations with high circulating magnesium. There was no association between circulating magnesium level and risk of SCD in intensive cardiac care unit (ICCU) patients, whilst the results were conflicting in congestive heart failure (CHF) patients.

Conclusion

High circulating magnesium might have the potential to be utilized as a risk stratification tool for SCD, especially in the general population. However, further study is needed to support this evidence.

Zusammenfassung

Hintergrund

Der plötzliche Herztod („sudden cardiac death“ [SCD]) ist eine der Hauptursachen für die kardiovaskuläre Mortalität und verantwortlich für 15–20 % der Todesfälle weltweit. Die derzeitige Stratifizierungsstrategie unter Verwendung einer reduzierten linksventrikulären Ejektionsfraktion reicht nicht aus, um das SCD-Risiko adäquat zu stratifizieren, besonders nicht in der Allgemeinbevölkerung. In den letzten Jahren wurden zunehmend Hinweise auf die antiarrhythmischen Eigenschaften von Magnesium gefunden. In der vorliegenden systematischen Übersicht untersuchen wir, ob zirkulierendes Magnesium ein potenzieller Parameter zur SCD-Risikostratifizierung ist.

Methoden

Diese systematische Übersicht basiert auf den Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) und wurde im Juli 2021 mit Quellen von Google Scholar, PubMed, Science Direct, EBSCO MEDLINE und ProQuest durchgeführt.

Ergebnisse

Insgesamt wurden 6 Studien in diese Übersichtsarbeit eingeschlossen. Drei in der Allgemeinbevölkerung durchgeführte Studien zeigten durchweg ein geringeres SCD-Risiko in Populationen mit hohem zirkulierendem Magnesium. Es gab keinen Zusammenhang zwischen dem Spiegel von zirkulierendem Magnesium und dem SCD-Risiko bei Patienten auf kardiologischen Intensivstationen. Die Ergebnisse bei Patienten mit Herzinsuffizienz („congestive heart failure“ [CHF]) waren widersprüchlich.

Schlussfolgerung

Ein hoher Spiegel von zirkulierendem Magnesium könnte ein potenzieller Parameter zur SCD-Risikostratifizierung sein, insbesondere in der Allgemeinbevölkerung. Es sind jedoch weitere Studien erforderlich, um dies zu belegen.

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Authors and Affiliations

  1. School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, 14440, Jakarta, Indonesia

    Edward Davis BMed, Bernard C. Fernando BMed, Louis Fabio Jonathan Jusni BMed, Kevin R. Hendryan BMed & Rexel Kuatama BMed

  2. Medical Education Unit, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Pluit Raya Rd. No. 2, 14440, North Jakarta, Indonesia

    Denio A. Ridjab MD, FESC

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  1. Edward Davis BMed
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  2. Bernard C. Fernando BMed
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  6. Denio A. Ridjab MD, FESC
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Correspondence to Denio A. Ridjab MD, FESC.

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Conflict of interest

E. Davis, B.C. Fernando, L.F.J. Jusni, K.R. Hendryan, R. Kuatama, and D.A. Ridjab declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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Davis, E., Fernando, B.C., Jusni, L.F.J. et al. Circulating magnesium as a potential risk stratification tool for sudden cardiac death: a systematic review. Herzschr Elektrophys 34, 153–160 (2023). https://doi.org/10.1007/s00399-023-00941-8

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