Pharmacological effects of magnesium salts in the treatment of AMI

Reducing peripheral vascular resistance:Magnesium has the effect of relaxing vascular smooth muscle.After supplementing with magnesium,peripheral vascular resistance is reduced,and the cardiac afterload is reduced.Therefore,supplementing magnesium can prevent and treat the occurrence of heart failure after myocardial infarction.

            (1)Coronary artery dilation:contact us deficiency increases the intracellular calcium concentration,which causes vasospasm,especially in coronary arteries with atherosclerosis.When magnesium deficiency occurs,the reactivity of blood vessels to various vasoconstricting substances increases,which can further increase coronary artery tension.Animal experiments have shown that supplementing magnesium can help repair and regenerate ischemic damaged blood vessels,increase collateral circulation,weaken vascular response to vasoconstrictors,increase endothelial release of endogenous soothing factors,and dilate coronary arteries.

            (2)Reducing infarct size:Magnesium deficiency causes vasospasm around the infarcted area.Magnesium deficiency can expand infarct size by promoting catecholamine induced myocardial necrosis and calcium overload in myocardial mitochondria,leading to impaired myocardial energy metabolism.Animal experiments have confirmed that supplementing magnesium can reduce the infarct area;This is related to the important effects of magnesium on coronary artery dilation,anticoagulation,inhibition of catecholamine release,and protection of myocardial function.The reduction of infarct size can reduce the incidence of heart failure,cardiogenic shock,and arrhythmia,thereby reducing the mortality rate of myocardial infarction.

            (3)Protecting myocardial function:Magnesium participates in all energy metabolism in the body.When magnesium is deficient,cell oxidative phosphorylation is inhibited,creatine phosphate is reduced,and ATP production is reduced.Magnesium supplementation can promote the recovery of myocardial metabolism to normal.Magnesium supplementation can also reduce the production of interleukin-2 and tumor necrosis factor,as well as myocardial damage caused by metalloproteinases.

            (4)Antiplatelet and anticoagulant effects:Magnesium has the ability to stabilize platelet membranes and inhibit platelet aggregation.Magnesium can inhibit various platelet aggregation promoters such as thromboxane A2,stimulate prostacyclin synthesis,and reduce endothelin-1,fibrinogen,and thromboxane B2.           

            (5)Reduce the generation of oxygen free radicals:Magnesium deficiency can cause a decrease in the natural antioxidant glutathione,oxide accumulation,induce lipid peroxidation,and increase the production of free radicals.After magnesium supplementation,the activity of superoxide dismutase(SOD)is restored,and the lipid peroxide metabolite malondialdehyde is reduced.Therefore,supplementing magnesium can alleviate the damage of oxygen free radicals to the myocardium.

            (6)Reducing peripheral vascular resistance:Magnesium has the effect of relaxing vascular smooth muscle.After supplementing with magnesium,peripheral vascular resistance is reduced,and the cardiac afterload is reduced.Therefore,supplementing magnesium can prevent and treat the occurrence of heart failure after myocardial infarction.

            (7)Reducing arrhythmias and sudden death:Magnesium ions have the ability to stabilize cell membrane potential and ion flow,thus magnesium salts have anti arrhythmic and preventive effects on sudden death.At least 10 prospective randomized double-blind clinical controlled trials have demonstrated the effectiveness and safety of magnesium salt in the treatment of acute myocardial infarction.Compared with the control group,the incidence of arrhythmia,heart failure,conduction disorders,angina,sudden death,and overall mortality were significantly reduced in the magnesium salt treatment group.The"Multi center Randomized Controlled Study on Early Treatment of Acute Myocardial Infarction with Potassium Magnesium Aspartate"published by the Collaborative Group for the Treatment of Acute Myocardial Infarction in China in 2002 also proved that magnesium salts can achieve good therapeutic effects in reducing mortality in early treatment of acute myocardial infarction.Therefore,magnesium preparations should be used as a routine adjuvant therapy in the early stage of acute myocardial infarction.