Adjunctive medical therapy for acute myocardial infarction.

Physicians should consider oxygen, morphine, nitrates, beta blockers, and aspirin as the foundation of early adjunctive treatment of acute myocardial infarction. An angiotensin-converting enzyme (ACE) inhibitor should be considered after 72 hours of adjunctive treatment. Intravenous heparin therapy is useful in certain subsets of patients, and intravenous magnesium therapy shows promise. With the exception of beta blockers, prophylactic antiarrhythmic agents are currently not indicated. We predict that combination therapy with aspirin, a beta blocker, and an ACE inhibitor will assume an ever-increasing role in treatment of myocardial infarction.