We measured changes in concentrations of magnesium, zinc, calcium, potassium, cholesterol [total and high-density lipoproteins (HDL)], total creatine kinase (CK), and CK isoenzyme-MB in plasma (PI) and/or erythrocytes (Erc) from apparently healthy subjects and from patients with either pre-infarction syndrome (PIS) or myocardial infarction (MI) with a favorable (MI1) or fatal (MI2) outcome, to assess the relationship of these changes to the increasing severity of ischemic disease. Significant sex-related differences led us to study men and women separately. In MI1 and MI2 patients, concentrations of Mg in PI and Erc were increased as a function of time since the infarct, confirming the cardiac Mg leaves the heart and enters the circulatory compartment. Compared with concentrations in MI2 patients, Zn concentrations in PI were lower in MI2 patients in the days before death. Significant negative correlations between Zn in PI in MI1 men or Zn in Erc in MI2 men and CK or CK isoenzyme MB suggest that circulating Zn is taken up by non-necrotic myocardial tissue as part of the repair process. MI2 patients had gradually decreasing Ca concentrations in PI even more marked than those observed in PIS and MI1 patients. We also noted a marked decrease in total and HDL cholesterol concentrations in both MI2 men and MI2 women shortly before death.