EDITORIALS
Has thrombolysis lost its mojo?
Correspondence to:
Dr J M Brophy, Divisions of Clinical Epidemiology and Cardiology, Royal Victoria Hospital, 687 Pine Avenue West, R4.12, Montreal, Quebec, Canada H3A 1A1; james.brophy@mcgill.ca
See article on page 1244
Keywords: acute myocardial infarction; epidemiology; primary angioplasty; thrombolysis
| The first 150 words of the full text of this article appear below. |
No man can be a pure specialist without being in the strict sense an idiot George Bernard Shaw
In this issue, Asseburg and colleagues report a systematic review of 22 randomised trials to assess the effectiveness of primary angioplasty compared with thrombolysis and its relationship to time delays (see article on page 1244).1 They conclude that angioplasty is superior provided that the additional time delay is less than 90 minutes. Although both a systematic review2 examining essentially the same studies and a meta-regression3 showing the importance of the additional time delays have been previously published, Asseburg’s work makes several unique contributions. First, it provides an updated review using full publications rather than abstracts, includes an additional study and makes several data corrections. Second, the authors have extended the analysis from 1 to 6 months’ follow-up. Finally, the authors have performed a more rigorous and comprehensive analysis using Bayesian
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