[Treatment of the acute phase of myocardial infarction with nitrates]

An historical background of the use of nitrates in the setting of acute myocardial infarction gives way to the successive steps this therapy gave in the last 15 years. The pioneer investigations of John Flaherty proving the usefulness of nitroglycerin in reducing infarct size followed by the works by Bussman and Jugdutt notably on the limitation of infarct size but also on the prevention of infarct expansion and ventricular wall thinning are reviewed. The adjunctive role of nitrates in thrombolytic therapy is appraised and its absolute and relative contraindications are pointed out. Finally and based on the statistical works by Yusuf, the real impact of nitrate therapy in mortality of acute myocardial infarction is emphasised.