Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Drs Pechlaner and Bellmann are concerned
about differences in medications between the 2 groups. It is important to
recognize that our trial compared 2 treatment strategies as they might actually
be used in the community. Therefore, other than use of aspirin immediately
at presentation in both arms and use of accelerated tissue plasminogen activator
followed by 48 hours of heparin in the thrombolytic therapy arm, there were
no protocol-required medications. Use of all other medications was determined
only by the treating physician, not by our protocol. Outcomes of the 2 strategies
of care as actually delivered in the community were the primary end points.
In addition, the relatively small sample size makes analysis of covariates
Aversano T. 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