Treatment of myocardial infarction and anginaBMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6977.465a (Published 18 February 1995) Cite this as: BMJ 1995;310:465
Review underestimated the benefit of early thrombolysis
- John Rawles
- Honorary senior lecturer in medicine Medicines Assessment Research Unit, University of Aberdeen, Medical School, Aberdeen AB9 2ZD
EDITOR,—In their article on the treatment of myocardial infarction and angina John McMurray and Andrew Rankin perpetuate a serious error, underestimating the benefit of earlier thrombolysis in acute myocardial infarction.1 Their figure 1 shows the loss of benefit within five weeks to be 1.6 per 1000 patients per hour of delay and is reproduced from the overview by the Fibrinolytic Therapy Trialists' Collaborative Group of all randomised trials of more than 1000 patients.2 The graph shows the absolute reduction in mortality with thrombolytic treatment by delay from onset of symptoms to randomisation.
The severity of infarction, however, is negatively related to the delay by the patient, which constitutes …