Serum magnesium and outcomes in heart failure with reduced ejection fraction: the GALACTIC-HF trial.

The authors evaluated the prognostic significance of magnesium concentrations in patients with HF with reduced ejection fraction (HFrEF) enrolled in GALACTIC-HF trial.

作者评估了在GALACTIC-HF试验中登记的射血分数降低的心力衰竭(HFrEF)患者中镁浓度的预后意义。

Methods

GALACTIC-HF was a randomized, double-blind, multicentre, event-driven trial that investigated the efficacy and safety of omecamtiv mecarbil compared with placebo in HF patients with left ventricular ejection fraction ≤ 35%.

GALACTIC-HF 是一项随机、双盲、多中心、事件驱动的试验，研究了与安慰剂相比，omicamtiv mecarbil 在左心室射血分数≤35%的心力衰竭患者中的疗效和安全性。

The primary outcome was the composite of a first worsening HF event or cardiovascular death.

主要结果是首次心力衰竭恶化事件或心血管死亡的复合终点。

Results

A total of 6147 outpatients had baseline serum magnesium data.

共有6147名门诊患者有基线血清镁数据。

Of these, 1082 (17.6%) had magnesium concentrations below .75 mmol/L, 4410 (71.7%) had concentrations within the normal range, and 655 (10.7%) had concentrations above .95 mmol/L.

在这些患者中，有1082名（占17.6%）的镁浓度低于0.75毫摩尔/升，

The incidencerate (per 100 person-years) for the primary composite outcome was highest in patients with hypermagnesaemia (34.9, 95% confidence interval31.2-39.0), while rates were similar between those with hypomagnesaemia (21.5, 19.4-23.8), and normal magnesium (20.9, 19.9-22.0).

主要复合结果的发生率（每100人年）在高镁血症患者中最高（34.9，95%置信区间31.2-39.0），而低镁血症（21.5，19.4-23.8）和正常镁血症（20.9，19.9-22.0）患者之间的发生率相似。

Similar trends were observed for the components of the primary outcome and all-cause death.

主要结果的组成部分和全因死亡率观察到类似的趋势。

The incidencerate of sudden death and ventricular tachyarrhythmia did not differ among the three magnesium groups, but the risk of death from worsening HF was highest in patients with hypermagnesaemia.

在三个镁水平组中，突发死亡和室性心动过速的发生率没有差异，但与正常镁浓度患者相比，高镁血症患者的慢性心力衰竭恶化死亡风险最高。

Conclusions

In GALACTIC-HF, 10.7% of outpatients with HFrEF had hypermagnesaemia, which was associated with a higher risk of the primary outcome compared with normal magnesium concentrations.

在GALACTIC-HF研究中，10.7%的HFrEF门诊患者存在高镁血症，与正常镁浓度相比，这与主要结局的更高风险相关。

Abnormal magnesium levels were not associated with a higher risk of sudden death or ventricular tachyarrhythmias.

异常的镁水平与突发死亡或室性心动过速的风险增加无关。

These findings do not support routine correction of hypomagnesaemia.

这些发现不支持常规纠正低镁血症。