Adjunctive therapy for acute myocardial infarction.

Based on results from a multitude of clinical trials of acute myocardial infarction, the beneficial role of a variety of pharmacologic agents, used in conjunction with thrombolytic therapy, has emerged. This is particularly true for aspirin, beta-blockers, heparin, and angiotensin-converting enzyme inhibitors. In addition, the dosage and timing of their administration have been shown to be crucial to their efficacy. The scientific and pathophysiologic basis as well as practical recommendations regarding their use are discussed. The exact role of nitrate therapy and potential for magnesium are presented in addition to data on agents that might be detrimental in the early stages of acute myocardial infarction.