Magnesium in acute myocardial infarction.

Clinical studies on the use of magnesium in acute myocardial infarction have yielded contradictory results. While the exact reasons for these discrepancies are unclear, it appears that the timing of magnesium administration is crucial to the success or failure of therapy. Although some studies have shown a significant reduction in the odds of death with this agent, the exact reasons underlying this possible benefit are not yet fully understood. A reduction in arrhythmias, inhibition of thrombus generation, changes in coronary and peripheral hemodynamics, and the limitation of ischemic damage and reperfusion injury have been inferred as possible mechanisms. IV magnesium is inexpensive and easy to administer, and has minimal side effects. While further research on magnesium therapy in ischemic states is warranted, the early use of IV magnesium should be considered in selected patients with suspected acute myocardial infarction.