Changing outcome in acute myocardial infarction.

Beta blockers, glucose-insulin-potassium, nitrates, and thrombolytic interventions have been demonstrated to reduce the mortality of acute MI. Because of the number of interventions available, it will become progressively more difficult to isolate their additional benefits. The next challenge will be to determine the ideal combination of interventions to limit infarct size maximally in the context of early reperfusion, thereby limiting reperfusion injury and further improving salvage.