Is the Use of t-PA as Compared with Streptokinase Cost Effective?

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Abstract
The conclusion by Mark et al. in their analysis of the cost effectiveness of thrombolytic therapy for acute myocardial infarction (May 25 issue)1 that the routine use of accelerated tissue plasminogen activator (t-PA) in patients with acute myocardial infarction would provide 3.5 million additional years of life after myocardial infarction appears to be a gross overstatement of the annual survival benefit. The authors' data do not support the contention that each of the 250,000 potentially eligible recipients of this therapy would gain 14 additional years of life from this treatment.

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