Abstract
Acute myocardial infarction (MI) is one of the most frequent causes of death in the United States. The evaluation and treatment of acute MI in conventional medicine has focused primarily on anatomical and physiological factors that lead to impaired blood flow. Less attention has been paid to metabolic factors that may influence the vulnerability of the myocardium to ischemia and to various stressors. There is evidence that in some cases inefficient cellular metabolism, rather than the availability of oxygen and other blood-borne nutrients, is an important factor determining whether cardiac pathology will develop. Metabolic dysfunction could result from intracellular deficiencies of magnesium, coenzyme Q10, carnitine, and certain B vitamins, nutrients which play a role in the synthesis of adenosine triphosphate (ATP; the body’s main storage form of energy). In addition, increased oxidative stress may contribute to the pathogenesis of both MI-related myocardial damage and reperfusion injury. Consequently, administration of antioxidants might improve outcomes in patients with acute MI. Numerous clinical trials have found parenteral administration of magnesium in the early stages of acute MI can substantially reduce the death rate. In addition, several trials have shown L-carnitine is beneficial in the treatment of acute MI. Other nutrients, such as vitamin C, vitamin E, and various B vitamins, may also be of value. (Altern Med Rev 2010;15(2):113-123)