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Abstract: SA-PO844

Significant Association between Serum Magnesium and the Elevation of Troponin T in Maintenance Hemodialysis Patients

Session Information

Category: Dialysis

  • 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular

Authors

  • Ishimura, Eiji, Meijibashi Hospital, Osaka, Japan
  • Nakatani, Shinya, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Tsuda, Akihiro, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Kuwamura, Nobuyuki, Meijibashi Hospital, Osaka, Japan
  • Kakiya, Ryusuke, Meijibashi Hospital, Osaka, Japan
  • Miyawaki, Jiro, Shirasagi Hospital, Osaka, Japan
  • Okuno, Senji, Shirasagi Hospital, Osaka, Japan
  • Yamakawa, Tomoyuki, Shirasagi Hospital, Osaka, Japan
  • Shoji, Shigeichi, Shirasagi Hospital, Osaka, Japan
  • Inaba, Masaaki, Osaka City University Graduate School of Medicine, Osaka, Japan
Background

Serum magnesium (Mg) levels is well known to be closely associated with cardiovascular disease in the general population. Troponin T has been reported to be a cardiac contractility modulating protein, and is measured as a biomarker for diagnosing myocardial injury. In hemodialysis patients, serum troponin T is elevated, and elevated serum troponin T has been reported to be a risk of death from all-cause mortality and cardiovascular disease. We hypothesized that serum Mg would be associated with the elevation of troponin T in hemodialysis patients.

Methods

A total of 432 stable maintenacne hemodialysis patients were examined (age: 64.0±11.3 years, hemodialysis duration: 8.0±6.9 years, 63.7% men, and 37.5% diabetics). Troponin T was measured twice in one year interval. Patients were divided into two groups; the group with elevation of serum troponin T in a year (98 patients) and the group with its non-elevation (334 patients).

Results

The group of elevation of serum troponin T showed significant older age, compared to the group of no-elevation of serum troponin T (67± 10 vs. 63 ± 12 vs. years, p = 0.0006) . Cardia thoracic ratio (CTR) was significantly larger in the former than in the latter (50.5 ± 4.7 vs. 49.3 ± 4.4 %, p = 0.0260) . Body mass index or duration of hemodialysis did not significantly differ between the two groups. Serum magnesium concentrations were significantly lower in the group of elevation of serum troponin T in a year, compared to the group of no elevation of serum troponin T in a year (2.6 ± 0.3 vs. 2.8 ± 0.4 mg/dL, p = 0.0015), although there were no significant differences in serum calcium, phosphate or intact PTH between the two groups. In a multivariate logistic analysis, serum Mg levels (OR = 0.394; 95% CI, 0.177 to 0.877; p = 0.0224) were significantly and independently associated with the elevation of troponin T, in addition to other significant factors of age, hemodialysis duration, and smoking (R2=0.097, p < 0.0001), after adjustment of several clinical factors.

Conclusion

These results demonstrated that lower serum Mg concentration was significantly associated with the elevation of troponin T in hemodialysis patients, possibly suggesting that significant association of lower serum Mg and higher cardiac injury.