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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 …
Competing interests None.
Provenance and Peer review Not commissioned; not externally peer reviewed.