Sefa Erdi Ömür, Gülşen Genç Tapar, Çağrı Zorlu, Kayıhan Karaman
Interventional Cardiology Perspectives - 2025;1(3):112-118
Background: Contrast-induced nephropathy (CIN) is the most common cause of hospital-acquired acute renal failure. The increased use of contrast media in diagnostic and interventional cardiac catheterization procedures and the increased frequency of these procedures have made CIN a common problem in clinical cardiology practice. Aim:The aim of our study was to understand the role of magnesium (Mg²+) levels in patients who developed CIN after non-ST elevation myocardial infarction (NSTEMI). Study Design: The study was conducted retrospectively and a total of 4,324 patients who applied to the cardiology clinic with NSTEMI were included in the study. Methods: This retrospective single-center study included 4,003 NSTEMI patients undergoing percutaneous coronary intervention (PCI). Patients with systemic inflammatory or rheumatologic diseases, hematologic disorders, renal or hepatic failure, infection, malignancy, or prior thrombolytic therapy were excluded. CIN was defined as an increase in serum creatinine >=25% or >=0.5 mg/dL within 48-72 hours after contrast exposure. Statistical analyses were performed using SPSS 26.0. Logistic regression identified independent predictors, and receiver operating characteristic (ROC) analysis determined the optimal magnesium cut-off for CIN prediction. Results: CIN occurred in 1,062 patients (26.5%). Patients who developed CIN were older and had higher rates of diabetes mellitus, lower systolic blood pressure, and lower left ventricular ejection fraction. Serum magnesium levels were significantly lower in patients with CIN. ROC analysis identified an Mg²+ cut-off of 2.13 mg/dL [area under the curve=0.745, 95% confidence interval (CI): 0.681-0.809, p<0.001; sensitivity 78%, specificity 76%]. In multivariate analysis, age, diabetes, systolic blood pressure, preprocedural creatinine, estimated glomerular filtration rate, and Mg²+ <2.13 mg/dL (OR=2.02, 95% CI: 1.71-2.31, p<0.001) were independent predictors of CIN. Conclusion: Low magnesium levels are independently associated with an increased risk of CIN in NSTEMI patients undergoing PCI. Routine assessment of Mg²+ before contrast exposure may help identify high-risk patients and improve prevention strategies.
