Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: We have several concerns about
the study by Dr Aversano and colleagues.1 First,
the study was only single-blind. Because of the nature of the randomized groups,
follow-up and management of patients with primary PCI could lead to unrecognized
bias introduced into the study in the form of preferential management of PCI
patients. This potential bias could have been minimized if enrolled patients
underwent cardiac angiography and then were randomized to receive thrombolysis
and mild catheter manipulation vs PCI and placebo "thrombolysis."
Yee A, Gabayan A, Carbajal EV. Thrombolytic Therapy vs Angioplasty in Acute Myocardial InfarctionThrombolytic Therapy vs Angioplasty in Acute Myocardial Infarction. JAMA. 2002;288(18):2263–2264. doi:10.1001/jama.288.18.2263