INTRAVENOUS-INFUSION OF MAGNESIUM SALTS I N ACUTE CORONARY SYNDROMES - IS THERE ANY BASIS FOR USE

Intensive investigation of influence of intravenous Infusion of magnes ium salts on clinical course and prognosis in acute myocardial infarct ion was started in the middle eighties. This Is a simple, safe, inexpe nsive, widely practicable intervention without any serious contraindic ation. Meta-analysis of eight prospective randomized double-blind plac ebo-controlled trials revealed that reduction of mortality caused by m agnesium was similar to that observed in patients treated with thrombo lytics, aspirin, or beta-blockers. The most likely mechanism of action of magnesium ion is reduction of heart failure development in early d ays after myocardial infarction but not reduction of lethal arrhythmia s as was thought early. however in the largest trial ISIS-4 no Influen ce of magnesium infusion over 24 hours on mortality during 35 days of patients with acute myocardial infarction war observed. Thus expedienc y of magnesium infusion In acute myocardial Infarction Is still debata ble.