THE SERUM CALCIUM TO MAGNESIUM RATIO IN PATIENTS WITH ACUTE CORONARY SYNDROME

Introduction: There is still uncertainty about the pathophysiological role of magnesium (Mg) in the course of acute coronary syndrome. Since Mg is considered to be natural physiologic 'calcium (Ca) antagonist', the balance between Ca and Mg seems to be more important to reflect its homoeostasis rather than the measurement of serum Mg level. Material and methods: A total of 92 patients (67 male, mean age 61.19 +/- 13.64 years) with the diagnosis of acute coronary syndrome were enrolled into this study. Patients were divided into 2 groups by non-ST-segment elevation myocardial infarction to ST segment elevation myocardial infarction. Clinical and demographic characteristics, and the results of blood samples within 24 hour of admission were evaluated. Results: The mean Ca/Mg ratio for the entire subject cohort on admission was 4.28 +/- 0.53. Although serum Ca level was not statistically significantly different between two groups, the patients with ST-segment elevation myocardial infarction were found to have significantly low levels of serum Mg as compared to the non-ST-segment elevation myocardial infarction group (p = 0.004). Consistently, ST-segment elevation myocardial infarction was associated with higher Ca/Mg ratio as compared those with non-ST segment elevation myocardial infarction. In multivariate linear regression analysis, acute coronary syndrome presentation (ST-segment elevation myocardial infarction or non-ST-segment elevation myocardial infarction) (Unstandardized Coefficients B = 0.262; 95%CI=0.048 - 0.476; p=0.017) and serum triglyceride (Unstandardized Coefficients B = -0.002; 95%CI=-0.001 -0.000; p=0.027) were found as independent predictors of serum Ca/Mg ratio. Conclusion: The serum Ca/Mg ratio is higher in ST-segment elevation myocardial infarction patients compared those with non-ST-segment elevation myocardial infarction. This could be because of a greater decrease in the levels of Mg than in those of Ca.