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November 13, 2002

Thrombolytic Therapy vs Angioplasty in Acute Myocardial InfarctionThrombolytic Therapy vs Angioplasty in Acute Myocardial Infarction

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2002;288(18):2263-2264. doi:10.1001/jama.288.18.2263

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 statistically problematic.

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