P. Yang et al., EFFECTS OF INTRAVENOUS MAGNESIUM THERAPY ON ISCHEMIA REPERFUSION INJURY IN ACUTE MYOCARDIAL-INFARCTION/, Magnesium-Bulletin, 18(4), 1996, pp. 104-106
The concept of reperfusion-induced injury has aroust special interest
over the past decade since early restoration of coronary blood flow pl
ays pivotal role in the treatment of patients with acute myocardial in
farction. There is experimental evidence that oxygen-derived free radi
cals, activation of the complement system, and adhesion molecules may
account for the development of reperfusion injury. Reduction of reperf
usion injury may be the mechanism underlying the beneficial effects of
magnesium in acute myocardial ischemia. Numerous previous clinical tr
ials on effects of intravenous magnesium in patients with acute myocar
dial infarction provided encouraging results with respect to mortality
benefit, infarct size reduction, and reduction of arrythmias. A recen
tly published large-scale trial, ISIS-4, however, failed to show the c
linical benefit of intravenous magnesium therapy, and caused major con
troversies in this field. It is suspected that the late timing of magn
esium therapy as was performed in ISIS-4 may be responsible for the ne
gative results. Further clinical trials have now been initiated to cla
rify the beneficial effects of magnesium in acute myocardial infarctio
n, with a special remark on optimal timing and dose regimen of intrave
nous magnesium therapy.