EDITOR,—As discussed by John Rawles and us,1 2 analysis of the “early thrombolysis” trials, and not just the Fibrinolytic Therapy Trialists' overview, suggests that giving thrombolysis 60 minutes earlier, a generally feasible time saving, will probably save at least 15 additional lives per 1000 patients treated. This conclusion is much less controversial than how the results of the GUSTO trial (global utilisation of streptokinase and tissue plasminogen activator for occluded arteries) should be interpreted. This controversy was reviewed by us, but two points should be emphasised.

Firstly, Anthony Hall and D M Humphreys fail to point out that the GUSTO trial was not just a comparison of two drugs. It was also a trial of …