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November 5, 1997

Thrombolytic Therapy for Elderly Patients With Myocardial Infarction

Author Affiliations

Marshall University Huntington, WVa

JAMA. 1997;278(17):1401. doi:10.1001/jama.1997.03550170031015

To the Editor.  —I congratulate Drs Gurwitz and Goldberg1 on their Editorial regarding the article by Dr Krumholz and colleagues2 on thrombolytic therapy in the elderly. However, I am surprised that no mention was made of the patient's functional capacity prior to hospitalization in relation to the decision to administer thrombolytic therapy. As far as I know, none of the studies on thrombolysis has addressed this issue. We, as investigators, get immersed in statistics and forget that humans are not immortal. Any effort to achieve immortality, in my opinion, is useless. If the age is ripe, we as a society should concentrate on comfort care and not heroics.We should devote our resources primarily to the productive and functional sector of society. Age is not a contraindication to any beneficial therapy, but the functional status of a given patient should be one of the most important considerations in

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