The Study of Serum Calcium to Magnesium Ratio in Patients with Acute Coronary Syndrome in a Tertiary Hospital, Hubli, Karnataka

Author(s): Uday Subhash Bande1, Kalinga Bommanakatte Eranaik2, Manjunath Shivalingappa Hiremani3, Basawantrao Kailash Patil4, Sushma Shankaragouda Biradar5

Cardiovascular diseases are one of the leading causes of morbidity and mortality
worldwide. High Ca levels and low Mg levels are associated with increased
cardiovascular risk in the general population.1 The balance between Ca and Mg
seems to play an important role in homeostasis since Mg is considered as
physiologic antagonist of Ca.2 Hence Ca/Mg ratio was considered to study its
association with acute coronary syndrome (ACS).
This is a case control study conducted in Karnataka Institute of Medical Sciences,
Hubli over a period of 2 years, February 2019 to December 2020. 200 cases and
150 controls were included in the study. The biochemical measurements
including complete blood count (CBC), cardiac biomarkers, liver function tests,
renal function tests (RFT), serum electrolytes and lipid profile were measured
using standard laboratory methods. Student ‘t’ test was used to compare the
data. Optimum cut-offs for diagnosis of acute myocardial infarction was
calculated using receiver operating characteristics (ROC) analysis. The
association among markers was established by calculating Pearson’s correlation.
Serum Ca/Mg ratio was significantly higher (p value < 0.001) in ACS when
compared to control groups. It was also found that Ca/Mg ratio was significantly
lower (p value < 0.001) in non-ST elevation myocardial infarction (NSTEMI)
when compared to STEMI group. Serum Mg was significantly lower (p value <
0.001) in ACS group when compared to control group. Significant correlation (p
value < 0.05) was found between serum Ca/Mg ratio and cardiac markers (CKMB,
Troponin-I). ROC analysis of Ca/Mg (4.19) ratios showed optimum cut-offs
in diagnosis of AMI.
Serum Ca/Mg could be useful adjuvant marker in diagnosis of AMI. The ratio is
higher in ST-segment elevation myocardial infarction when compared to non-STsegment
myocardial infarction, which could be due to greater decrease in Mg
levels when compared Ca in ACS.