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The impact of prehospital thrombolytic treatment on re-infarction rates
  1. J N Townend1,
  2. H C Routledge2
  1. 1
    Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK
  2. 2
    Worcestershire Royal Hospital, Worcester, UK
  1. Correspondence to Dr J N Townend, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK; john.townend{at}

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To the editor: We congratulate Horne and colleagues1 for their paper drawing attention to the high risk of re-infarction for patients receiving prehospital thrombolytic therapy for ST-segment elevation myocardial infarction. We disagree with their main conclusion that the major cause of this is underdosing with heparin and delay in commencing a heparin infusion. We suspect that the main factor …

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