Nitroglycerin therapy in acute myocardial infarction--an overview.

Nitroglycerin and nitrates have long been contraindicated in the treatment of acute myocardial infarction. Beneficial effects, however, are reported in patients with left ventricular failure. In this report the available data from the literature are reviewed with respect to the influence of the drug on myocardial ischemia, infarct size and necrosis as well as on ventricular arrhythmias and prognosis. All authors have confirmed a beneficial influence of nitroglycerin on myocardial ischemia and QRS signs of necrosis. Some authors have demonstrated a reduction in CK and CKMB activity. Ischemia-related ventricular dysrhythmias were also effectively reduced. Some promising data are available on prognosis.