Clinical factors associated with hypomagnesemia among patients with cardiac conditions: cross-sectional study

SPMC J Health Care Serv. 2018;4(1):2 ARK:

Arlyn Gaballo Awing,1 2 Aryeel Llanos3 4 5 6 7

1Misamis Oriental Provincial Hospital - Gingoog, Doña Graciana St, San Miguel, Gingoog City, Misamis Oriental, Philippines
2Agusan del Norte Provincial Hospital, Butuan City, Agusan del Norte, Philippines
3Department of Internal Medicine, Davao Regional Medical Center, Apokon, Tagum City, Philippines
4Bishop Joseph Regan Memorial Hospital, Christ the King Road, Tagum City, Davao del Norte, Philippines
5Medical Mission Group Hospital and Health Services Cooperative of Tagum, Department of Trade and Industry - Davao del Norte Field Office, Tagum City, Davao del Norte, Philippines
6Tagum Doctors Hospital Inc, National Highway, 54 Rabe Subdivision, Tagum City, Davao del Norte, Philippines
7Aquino Medical Specialists Hospital Inc, Mabini St, Tagum City, Davao del Norte, Philippines

Correspondence Arlyn Gaballo Awing,
Article editors Emily Doliente-Gavarra, Jay Lord Canag
Received 5 July 2017
Accepted 4 April 2018
Cite as Awing AG, Llanos A. Clinical factors associated with hypomagnesemia among patients with cardiac conditions: cross-sectional study. SPMC J Health Care Serv. 2017;4(1):2.


Background. Serum magnesium levels are usually measured and corrected, if warranted, among patients with cardiac diseases.

Objective. To determine the rate of and clinical factors associated with hypomagnesemia among patients with cardiac conditions.

Design. Cross-sectional study.

Setting. Davao Regional Medical Center (DRMC) in Tagum City, Philippines, from January 2014 to January 2016.

Participants. 59 males and 53 females with cardiac diagnoses and serum magnesium level determination results.

Main outcome measures. Rate of hypomagnesemia, odds ratios (95% CI) of having hypomagnesemia for selected clinical factors.

Main results. The mean age of the patients was 60.72 ± 16.73 years. The mean serum magnesium level was 0.75 ± 0.23 mmol/L, and 47/112 (41.96%) had hypomagnesemia (serum magnesium <0.7 mmol/L). Unadjusted prevalence odds ratios (POR) for having hypomagnesemia were significantly high for chronic obstructive pulmonary disease (COPD) comorbidity (POR=5.50; 95% CI 1.09 to 27.76; p=0.0392), stroke comorbidity (POR=2.78; 95% CI 1.15 to 6.71; p=0.0227), taking diuretic medications (POR=4.66; 95% CI 1.38 to 15.71; p=0.0132), and having atrial fibrillation during the admission (POR=2.26; 95% CI 1.04 to 4.91; p=0.0394).

Conclusion. In this study, 41.96% of the patients had hypomagnesemia. COPD and stroke comorbidities, diuretic therapy, and atrial fibrillation among patients with cardiac conditions were all significantly associated with hypomagnesemia.

Keywords. serum magnesium, atrial fibrillation, stroke, chronic obstructive pulmonary disease, diuretics


Serum magnesium levels are monitored and, if necessary, corrected as part of the management of patients with cardiac disease.1 2 3 4 5 Magnesium helps maintain cardiac rhythm,6 7 and certain cardiac arrhythmias are associated with hypomagnesemia.8 9 Hypermagnesuria10 11 and low serum magnesium levels12 13 have also been observed among patients on digoxin. Outside of these associations, little is known about the relationship of certain clinical characteristics with hypomagnesemia among patients with cardiac disease.

Arrhythmias often complicate structural heart diseases, acute coronary syndromes, and other cardiac conditions, and cause significant morbidity or even death.14 15 16 17 The knowledge of clinical characteristics that frequently accompany hypomagnesemia among patients with different heart diseases can better inform clinicians about the expected course of illness and appropriate diagnostic management of patients in this context. We did this study in order to determine the rate of hypomagnesemia among patients with cardiac conditions and to identify clinical factors associated with low magnesium levels among patients in this subgroup.


Study design and setting
We conducted a cross-sectional study based on the medical records of patients with cardiac diseases admitted at Davao Regional Medical Center (DRMC) in Tagum City, Philippines from January 2014 to January 2016. DRMC is a tertiary care hospital in Southern Philippines. Patients under the Internal Medicine Department with cardiac conditions are usually admitted in the general medical ward, the medical intensive care unit, or the coronary care unit of the hospital.

Patients aged 14 years old and over, diagnosed and admitted for any cardiac disease, and with at least one laboratory result of serum magnesium level during admission were eligible for inclusion into the study. We excluded patients with history of recurrent hypokalemia, as well as those who transferred to other institutions or went home against medical advice after serum magnesium level determination. We estimated the sample size for this study using StatCalc from Epi Info™ based on the assumptions that 30% of patients with cardiac conditions have hypomagnesemia, and that 50% of patients with hypomagnesemia have premature ventricular complexes (PVC), a common type of cardiac arrhythmia, while 21% of patients without hypomagnesemia have PVC.18 In a computation for odds ratio to determine the association of selected clinical factors with hypomagnesemia carried out with <5% level of significance, a total sample size of 112 patients will have 80% power of rejecting the null hypothesis—no significant increase or decrease in odds ratio—if the alternative holds.

Data collection
From the medical records of each patient, we collected data on age, sex, cardiac disease diagnosis, comorbidities (hypertension, diabetes mellitus, dyslipidemia, chronic obstructive pulmonary disease, acute renal failure, chronic renal failure, stroke and malignancy), and use of digoxin, steroids, and diuretics. We also collected data on documented occurrence of any cardiac arrhythmias and/or death during admission. Finally, we also noted the serum magnesium level for each patient. For a patient who had two or more serum magnesium levels in the medical records, we only collected the value of the first serum magnesium level taken closest to the admission date. We considered hypomagnesemia when the patient’s serum magnesium level was <0.7 mmol/L.

Statistical analysis
We summarized continuous variables as means and standard deviation and compared means using t-test. We summarized categorical variables as frequencies and percentages and compared proportions using chi-square test or Fisher’s exact test. Association of variables were expressed as prevalence odds ratios (POR) and their 95% confidence intervals. We performed univariate logistic regression to determine the unadjusted association of clinical factors with hypomagnesemia. We also performed multivariable logistic regression analysis of individual medical comorbidities, medications, and clinical events for their association with hypomagnesemia adjusted for age, sex, and cardiac diagnosis. We used Epi Info™ 7.2.1 for all our statistical tests.


A total of 112 patients were included in this analysis. There were 59/112 (52.68%) males and 53/112 (47.32%) females, and the mean age of the patients was 60.72 ± 16.73 years (range: 17 to 95 years). The mean serum magnesium level was 0.75 ± 0.23 mmol/L among all the patients, and 47/112 (41.96%) had hypomagnesemia. Table 1 shows the demographic and clinical profile of patients both as total sample and as divided according to the presence or absence of hypomagnesemia. Compared to the group without hypomagnesemia, the group with hypomagnesemia had significantly higher proportions of patients with chronic obstructive pulmonary disease (7/47, 14.89% versus 2/65, 3.08%; p=0.0336), stroke (17/47, 36.17% versus 11/65, 16.92%; p=0.0203), and documented atrial fibrillation during admission (31/47, 65.96% versus 30/65, 46.15%; p=0.0378). There was also a significantly higher proportion of patients on diuretics in the hypomagnesemia group than in the non-hypomagnesemia group (11/47, 23.40% versus 4/65, 6.15%; p=0.0082).

Table 1    Clinical characteristics of patients
Characteristics Total
With Hypomagnesemia
Without Hypomagnesemia
Mean age ± SD, years 60.72 ± 16.73 62.38 ± 17.69 59.52 ± 16.03 0.3715
Sex, frequency (%) 0.9263
   Male 59 (52.68) 25 (53.19) 34 (52.31)
   Female 53 (47.32) 22 (46.81) 31 (47.69)
Cardiac diagnoses, frequency (%)*
   Stable angina 38 (33.93) 19 (40.43) 19 (29.23) 0.2168
   Unstable angina 8 (7.14) 2 (4.26) 6 (9.23) 0.4644†
   NSTEMI 30 (26.79) 14 (29.79) 16 (24.62) 0.5419
   STEMI 16 (14.29) 6 (12.77) 10 (15.38) 0.6359
   Congenital heart disease 1 (0.89) 0(0) 1 (100.00) 1.0000†
   Dilated cardiomyopathy 10 (8.93) 3 (6.38) 7 (10.77) 0.5158†
   Rheumatic heart disease 5 (4.46) 1 (2.13) 4 (6.15) 0.3966†
   Valvular heart disease 3 (2.68) 1 (2.13) 2 (3.08) 1.0000†
   Thyrotoxic heart disease 7 (6.25) 2 (4.26) 5 (7.69) 0.6970†
Medical comorbidities, frequency (%)*
   Heart failure 71 (63.39) 28 (59.57) 43 (66.15) 0.4757
   Hypertension 69 (61.61) 32 (68.09) 37 (56.92) 0.2452
   Diabetes mellitus 25 (22.32) 11 (23.40) 14 (21.54) 0.8150
   Dyslipidemia 9 (8.04) 3 (6.38) 6 (9.23) 0.7319†
   COPD 9 (8.04) 7 (14.89) 2 (3.08) 0.0336†‡
   Acute renal failure 28 (25.00) 13 (27.66) 15 (23.08) 0.5804
   Chronic renal failure 7 (6.25) 5 (10.64) 2 (3.08) 0.1283†
   Stroke 28 (25.00) 17 (36.17) 11 (16.92) 0.0203†
Medication, frequency (%)*
   Digoxin 7 (6.25) 4 (8.51) 3 (4.62) 0.4505†
   Steroids 5 (4.46) 4 (8.51) 1 (1.54) 0.1594†
   Diuretics 15 (13.39) 11 (23.40) 4 (6.15) 0.0082†‡
Clinical events, frequency (%)*
   Atrial fibrillation 61 (54.46) 31 (65.96) 30 (46.15) 0.0378‡
   Ventricular tachycardia 5 (4.46) 1 (2.13) 4 (6.15) 0.3966†
   Died 18 (16.07) 5 (10.64) 13 (20.00) 0.1830
*One patient may have more than one cardiac diagnosis, medical comorbidity, medication, or clinical event.
†Compared using Fisher’s exact test.
‡Significant at p<0.05.
COPD—chronic obstructive pulmonary disease; NSTEMI—Non-ST-elevation myocardial infarction; STEMI—ST-elevation myocardial infarction.

Table 2 shows the association of selected clinical factors with hypomagnesemia on univariate logistic regression analysis. COPD comorbidity (POR=5.50; 95% CI 1.09 to 27.76; p=0.0392), stroke comorbidity (POR=2.78; 95% CI 1.15 to 6.71; p=0.0227), diuretic therapy (POR=4.66; 95% CI 1.38 to 15.71; p=0.0132), and documented atrial fibrillation during admission (POR=2.26; 95% CI 1.04 to 4.91; p=0.0394) were all significantly associated with hypomagnesemia. After adjusting for age, sex and cardiac diagnosis (Table 2), COPD comorbidity (adjusted POR=6.54; 95% CI 1.03 to 41.66; p=0.0469), diuretic therapy (adjusted POR=4.92; 95% CI 1.32 to 18.31; p=0.0175), and documented atrial fibrillation during admission (adjusted POR=3.12; 95% CI 1.22 to 7.96; p=0.0171) remained to be associated with hypomagnesemia.

Table 2    Logistic regression analysis showing the association of selected clinical factors with hypomagnesemia
Clinical factors Unadjusted Adjusted*
Prevalence odds ratio
(95% CI)
p-value Prevalence odds ratio
(95% CI)
Medical comorbidities
   Hypertension 1.61 (0.74 to 3.54) 0.2321 1.26 (0.51 to 3.11) 0.6120
   Heart failure 0.75 (0.35 to 1.64) 0.4761 0.79 (0.32 to 1.91) 0.5949
   Diabetes mellitus 1.11 (0.45 to 2.73) 0.8142 0.94 (0.36 to 2.41) 0.8903
   Dyslipidemia 0.67 (0.16 to 2.83) 0.5863 0.64 (0.14 to 2.94) 0.5646
   COPD 5.50 (1.09 to 27.76) 0.0392† 6.54 (1.03 to 41.66) 0.0469†
   Acure renal failure 1.27 (0.54 to 3.02) 0.5809 1.34 (0.52 to 3.43) 0.5450
   Chronic renal failure 3.75 (0.69 to 20.23) 0.1244 3.18 (0.56 to 18.19) 0.1933
   Stroke 2.78 (1.15 to 6.71) 0.0227† 2.48 (0.95 to 6.43) 0.0624
   Digoxin 1.92 (0.41 to 9.03) 0.4075 13.69 (0.91 to 207.11) 0.0589
   Steroids 5.95 (0.64 to 55.1 0) 0.1161 6.44 (0.54 to 76.91) 0.1412
   Diuretics 4.66 (1.38 to 15.71) 0.0132† 4.92 (1.32 to 18.31) 0.0175†
Clinical events
   Atrial fibrillation 2.26 (1.04 to 4.91) 0.0394† 3.12 (1.22 to 7.96) 0.0171†
   Ventricular tachycardia 0.33 (0.04 to 3.07) 0.3307 0.31 (0.03 to 3.31) 0.3296
   Death 0.48 (0.16 to 1.44) 0.1905 0.48 (0.15 to 1.57) 0.2265
*For age, sex, and cardiac diagnosis
†Significant at p<0.05.
COPD—chronic obstructive pulmonary disease; NSTEMI—Non-ST-elevation myocardial infarction; STEMI—ST-elevation myocardial infarction.


Key results
The rate of hypomagnesemia among patients with cardiac conditions in this study was 41.96%. We found out that COPD comorbidity, stroke comorbidity, diuretic therapy, and documented atrial fibrillation during admission among patients with cardiac conditions were associated with hypomagnesemia.

Strengths and limitations
We were able to estimate the rate of hypomagnesemia and determine the factors associated with low serum magnesium levels among patients with cardiac conditions in this study. Since our study had a cross-sectional design, and temporal or causal relationships of the factors associated with hypomagnesemia could not be ascertained, great caution should be exercised in the interpretation of these statistical associations.

In this study, the odds of having hypomagnesemia were 4.6 times as high among patients on diuretic medications than among those who were not taking diuretics. The use of diuretic agents have been linked to hypomagnesemia.19 Thiazides and loop-diuretics are mainly responsible for renal magnesium loss.20 21 It has been proposed that loop diuretics and osmotic diuretics increase magnesium excretion by increasing flow rate into the Henle’s loop and decreasing sodium chloride transport.22

Magnesium has been thought to play a role in the relaxation of bronchial smooth muscles.23 Low levels of serum magnesium have been associated with impaired pulmonary function, hyper-reactivity of the airways, and exacerbation of COPD.24 On the other hand, magnesium sulfate administration for acute bronchospasm has been reported to improve airway function.25 26 27 One interpretation of the association of hypomagnesemia with COPD comorbidity in our study is that it follows this exposure-outcome framework. However, based on the retrospective data that we collected in this study, we could not establish the exacerbation status of patients with recorded COPD comorbidity.

Cardiac arrhythmias and hypomagnesemia have been reported to occur concomitantly.20 28 Atrial fibrillation is the most common dysrhythmia, which occurs in 0.4% to 1.0% of the population.29 Magnesium is a cofactor in the sodium-potassium pump, and during hypomagnesemia, disruption in the function of the sodium-potassium pump can lead to abnormalities in the cardiac conduction system.4 Clinically, magnesium administration has a role in restoring sinus rhythm during atrial fibrillation.30 In our study, the odds of having atrial fibrillation were 2.26 times as high among patients with hypomagnesemia than among those without hypomagnesemia. Patients with atrial fibrillation would benefit from strict monitoring to detect hypomagnesemia that needs correction.31

It is not completely understood whether low magnesium levels promote the occurrence of stroke or vice versa. Relatively low serum magnesium levels have been observed among patients with stroke, and it has been suggested that the severity of cerebrovascular injury is inversely proportional to the serum magnesium levels.32 The neurological symptoms of hypomagnesemia, including mental status changes and acute focal deficits notably, can also mimic stroke in the clinical setting.33 Another possible explanation for the association of stroke with hypomagnesemia in this study is the strong association of hypomagnesemia and atrial fibrillation, which is a risk factor for stroke.34 35 After adjustment for age, sex, and cardiac diagnosis in this study, however, the association of stroke and hypomagnesemia did not show statistical significance, suggesting that the association is possibly mediated by other factors that modify stroke, hypomagnesemia, or both.

Hypomagnesemia is present in 20.2% of hospitalized patients.36 Several other studies reported varying rates of hypomagnesemia among different patient subgroups—6.59% among patients in the emergency room,37 8.75% to 18% among patients on dialysis,38 39 40 17.4% among patients with congestive heart failure,21 23.96% among patients in intensive care units,41 33.6% among patients with intracerebral hemorrhage,42 and 36% among elderly patients on long-term care.43 The rate of hypomagnesemia among patients with cardiac conditions in our study (41.96%) is higher than those reported in previous studies. The presence of several conditions associated with hypomagnesemia, such as concomitant COPD, stroke, or atrial fibrillation, can possibly account for this high rate of hypomagnesemia. Diuretic agents are commonly prescribed to patients with cardiac conditions complicated by heart failure, and this may also—at least partly—explain the high rate of hypomagnesemia among the patients with cardiac conditions in our study.

The results of this study are applicable to most patients with cardiac diagnoses since the clinical and demographic characteristics of our patients are similar to those of patients in other tertiary care hospitals. Males and females were equally represented in our study, and the age range of patients we included was quite broad. The most common cardiac diagnoses and their comorbidities were also well-represented among the patients in our study sample.


Among patients with cardiac conditions in this cross-sectional study, 41.96% had hypomagnesemia. COPD comorbidity, stroke comorbidity, diuretic therapy, and documented atrial fibrillation during admission were significantly associated with low serum magnesium levels.

In essence

For patients with cardiac conditions, keeping serum magnesium levels within normal limits is usually part of the therapeutic management.

In this study among patients with various cardiac diagnoses, 41.96% had hypomagnesemia.

Chronic obstructive pulmonary disease comorbidity, stroke comorbidity, taking diuretic medications, and documented atrial fibrillation during admission were all associated with hypomagnesemia.


We would like to thank Ms Aileen Ceballos for her assistance in the implementation of this research, and Dr Dizza R Dujali for reviewing the protocol and final report of this research.

Ethics approval

This study was reviewed and approved by the Department of Health XI Cluster Ethics Review Committee (DOH XI CERC reference P16060701).

Reporting guideline used

STROBE Checklist (

Article source


Peer review



Supported by personal funds of the authors

Competing interests

None declared

Access and license

This is an Open Access article licensed under the Creative Commons Attribution-NonCommercial 4.0 International License, which allows others to share and adapt the work, provided that derivative works bear appropriate citation to this original work and are not used for commercial purposes. To view a copy of this license, visit


1. Rasmussen HS, McNair P, Gøransson L, Balsløv S, Larsen OG, Aurup. Magnesium deficiency in patients with ischemic heart disease with and without acute myocardial infarction uncovered by an intravenous loading test. Arch Intern Med. 1988;148(2):329-332.

2. Longo DL, Kasper DL, Fauci AS, Hauser SL, Jameson JL, Loscalzo J. Harrison’s principles of internal medicine. 19th ed. New York: Mcgraw Hill; 2015.

3. Ceremuzynski L, Van Hao N. Ventricular arrhythmias late after myocardial infarction are related to hypomagnesemia and magnesium loss: preliminary trial of corrective therapy. Clin Cardiol. 1993;16(6):493-6.

4. Khan AM, Lubitz SA, Sullivan LM, Sun JX, Levy D, Vasan RS et al. Low serum magnesium and the development of atrial fibrillation in the community: the Framingham Heart Study. Circ Res. 2013;127(1):33-8.

5. Horner SM. Efficacy of intravenous magnesium in acute myocardial infarction in reducing arrhythmias and mortality. Meta-analysis of magnesium in acute myocardial infarction. Circ Res. 1992;86(3):774-9.

6. Falco CN, Grupi C, Sosa E, Scanavacca M, Hachul D, Lara S et al. Successful improvement of frequency and symptoms of premature complexes after oral magnesium administration. Arq Bras Cardiol. 2012;98(6):480-7.

7. Volpe SL. Magnesium and the Athlete. Curr Sports Med Rep. 2015;14(4):279-83.

8. Wu J, Carter A. Magnesium: the forgotten electrolyte. Aust Prescr. 2007;30:102-5.

9. Roden DM. Magnesium treatment of ventricular arrhythmias. Am J Cardiol. 1989;63(14):43g-46g.

10. Zanoli L, Lentini P, Fatuzzo P. Digoxin and Hypermagnesuria. Nephron. 2018;138(2):89-91.

11. Abu-Amer N, Priel E, Karlish SJD, Farfel Z, Mayan H. Hypermagnesuria in Humans Following Acute Intravenous Administration of Digoxin. Nephron. 2018;138(2):113-118.

12. Young IS, Goh EM, McKillop UH, Stanford CF, Nicholls DP, Trimble ER. Magnesium status and digoxin toxicity. Br J Clin Pharmacol. 1991;32(6):717-21.

13. Raja Rao MP, Panduranga P, Sulaiman K, Al-Jufaili M. Digoxin toxicity with normal digoxin and serum potassium levels: beware of magnesium, the hidden malefactor. J Emerg Med. 2013;45(2):e31-4.

14. London B. Arrhythmias. In: Ginsburg G, Willard H. Genomic and personalized medicine. 2nd ed. New York: Elsevier; 2013. p. 1231-1249.

15. Gorenek B, Blomström-Lundqvist C, Terradellas JB, Camm AJ, Hindricks G, Huber K et al. Cardiac arrhythmias in acute coronary syndromes: position paper from the joint EHRA, ACCA, and EAPCI task force. EP Europace. 2018;16(11):1655-1673.

16. Betensky BP, Dixit S. Sudden cardiac death in patients with nonischemic cardiomyopathy. Indian Heart J. 2014;66(Suppl 1):S35-S45.

17. Tsymbaliuk BP, Unukovych D, Shvets, N, Dinets A. Cardiovascular complications secondary to graves’ disease: A prospective study from Ukraine. Plos One. 2015;10(3):e0122388.

18. Del Gobbo LC, Song Y, Poirier P, Dewailly E, Elin RJ, Egeland GM. Low serum magnesium concentrations are associated with a high prevalence of premature ventricular complexes in obese adults with type 2 diabetes. Cardiovasc Diabetol. 2012; 11:23.

19. Madias JE, Sheth K, Mubashar A, Choudry, Berger DO, Madias NE. Admission serum magnesium level does not predict the hospital outcome of patients with acute myocardial infarction. Arch Intern Med. 1996;156(15):1701-1708.

20. Efstratiadis G, Sarigianni M, Gougourelas I. Hypomagnesemia and cardiovascular system. Hippokratia. 2006;10(4):147-52.

21. ilionis HJ, Alexandrides GE, Liberopoulos EN, Bairaktari ET, Goudevenos J, Elisaf MS. Hypomagnesemia and concurrent acid-base and electrolyte abnormalities in patients with congestive heart failure. Eur J Heart Fail. 2002;4(2):167-73.

22. Davies DL, Fraser R. Do diuretics cause magnesium deficiency? Br J clin Pharmac. 1993;36: 1-10.

23. Gourgoulianis KI, Chatziparasidis G, Chatziefthimiou A, Molyvdas PA. Magnesium as a relaxing factor of airway smooth muscles. J Aerosol Med. 2001;14(3):301-7.

24. Azis, HS. (2005), Serum magnesium levels and accute exacerbation of chronic obstructive pulmonary disease: a retrospective study. Autum;35(4):423-7.

25. Alter HJ, Koepsell TD, Hilty WM. Intravenous magnesium as an adjuvant in acute bronchospasm: a meta-analysis. Ann Emerg Med. 2000;36(3):191-7.

26. Hughes R, Goldkorn A, Masoli M, Weatherall M, Burgess C, Beasley R. Use of isotonic nebulised magnesium sulphate as an adjuvant to salbutamol in treatment of severe asthma in adults: randomised placebo-controlled trial. Lancet. 2003;361(9375):2114-7.

27. Roy SR, Milgrom H. Managing outpatient asthma exacerbations. Curr Allergy Asthma Rep. 2003 Mar;3(2):179-89.

28. Nair RR, Nair P. Alteration of myocardial mechanics in marginal magnesium deficiency. Magnes Res. 2002 Dec;15(3-4):287-306.

29. Dresing TJ, Schweikert RA. Atrial fibrillation. In: Current clinical medicine. 2nd ed. Cleveland, OH: Saunders; 2010. p. 129-137.e1.

30. Onalan O, Crystal E, Daoulah A, Lau C, Crystal A, Lashevsky I. Meta-analysis of magnesium therapy for the acute management of rapid atrial fibrillation. Am J Cardiol. 2007;99(12):1726-32.

31. DeCarli C, Sprouse G, LaRosa JC. Serum magnesium levels in symptomatic atrial fibrillation and their relation to rhythm control by intravenous digoxin. Am J Cardiol. 1986 Apr 15;57(11):956-9.

32. Cojocaru IM, Cojocaru M, Burcin C, Atanasiu NA. Serum magnesium in patients with acute ischemic stroke. Rom J Intern Med. 2007; 45(3):269-73.

33. Rico M, Martinez-Rodriguez L, Larrosa-Campo D, Calleja S. Dilemma in the emergency setting: hypomagnesemia mimicking acute stroke. Int Med Case Rep J. 2016;9:145-8.

34. Yuan Z, Bowlin S, Einstadter D, Cebul RD, Conners AR Jr, Rimm AA. Atrial fibrillation as a risk factor for stroke: a retrospective cohort study of hospitalized Medicare beneficiaries. Am J Public Health. 1998;88(3):395-400.

35. Hald EM, Rinde LB, Lochen ML, Mathiesen EB, Wilsgaard T, Njolstad I et al. Atrial fibrillation and cause-specific risks of pulmonary embolism and ischemic stroke. J Am Heart Assoc. 2018;7(3).

36. Cheungpasitporn W, Thongprayoon C, Qian Q. Dysmagnesemia in hospitalized patients: prevalence and prognostic importance. Mayo Clin Proc. 2015;90(8):1001-10.

37. Haider DG, Lindner G, Ahmad SS, Sauter T, Wolzt M, Leichtle AB et al. Hypermagnesemia is a strong independent risk factor for mortality in critically ill patients: Results from a cross-sectional study. Eur J Case Rep Intern Med. 2015;26(7):504-507.

38. Cai K, Luo Q, Dai Z, Zhu B, Fei J, Xue C et al. Hypomagnesemia is associated with increased mortality among peritoneal dialysis patients. PLoS One. 2016;11(3):e0152488.

39. Nakashima A, Ohkido I, Yokoyama K, Mafune A, Urashima M, Yokoo T. Proton pump inhibitor use and magnesium concentrations in hemodialysis patients: A cross-sectional study. PLoS One. 2015;10(11).

40. Yang X, Soohoo M, Streja E, Rivara MB, Obi Y, Adams SV et al. Serum magnesium levels and hospitalization and mortality in incident peritoneal dialysis patients: A cohort study. Am J Kidney Dis. 2016;68(4):619-27.

41. Charles BS, Menon I, Girish TS, Cherian AM. Hypomagnesemia in the ICU – Does Correction Matter? J Assoc Physicians India. 2016 Nov;64(11):15-19.

42. Behrouz R, Hafeez S, Mutgi SA, Zakaria A, Miller CM. Hypomagnesemia in Intracerebral Hemorrhage. World Neurosurg. 2015 Dec;84(6):1929-32.

43. Arinzon Z, Peisakh A, Schrire S, Berner YN. Prevalence of hypomagnesemia (HM) in a geriatric long-term care (LTC) setting. Arch Gerontol Geriatr. 2010; 51(1):36-40.

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June 25, 2017

Volume 4 Issue 1 (2018)