While clinical medicine continues to evaluate the necessity of various interventions, the routine use and significance of serum magnesium testing and intravenous (IV) magnesium treatments for heart failure (HF) remain uncertain. To bridge this knowledge gap, CVC researchers analyzed 78,957 acute HF episodes recorded in Alberta between 2012 and 2020. This retrospective study investigates whether these common interventions genuinely benefit patient recovery.
While 58.7% of patients were tested for hypomagnesemia (abnormally low magnesium levels), the study found that the relationship between magnesium and patient outcomes was complex. Among those tested, 31.7% were found to be deficient. However, the data revealed a non-linear relationship between magnesium levels and mortality: both very low levels and elevated levels were independently associated with an increased risk of death.
Perhaps most notable was the impact of IV magnesium supplementation. Administered to 13.7% of tested patients—including 29.7% of those without hypomagnesemia—IV treatment was associated with a higher risk of short-term mortality and an increase in hospitalization risk after adjusting for other variables.
These findings suggest that routine magnesium supplementation in acute HF may not only lack benefit but could potentially be harmful. This study underscores a vital need to reevaluate standard protocols and conduct further research to determine when, or if, magnesium intervention is truly safe for these patients.
This study was led by CVC trainee Robert Margaryan, MSc, under the supervision of Justin Ezekowitz, MBBCh, MSc. It was conducted in collaboration with Sunjidatul Islam, MBBS, MSc; Douglas Dover, PhD; Finlay McAlister, MD, MSc; and Padma Kaul, PhD.
