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Thrombolytic Agents: The Science of the Art of Choosing the Better Treatment

Michael E. Farkouh, MD; Jeff D. Lang, MD; and David L. Sackett, MD, MSc
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Departments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. Requests for Reprints: David L. Sackett, MD, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 5, Headington, Oxford OX3 9DU, United Kingdom.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1994;120(10):886-888. doi:10.7326/0003-4819-120-10-199405150-00011
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The current dispute about whether the thrombolytic agent of choice for patients with suspected heart attacks should be tissue plasminogen activator (tPA) or streptokinase is succulent. It invokes arguments across the spectrum of health research, from bench to bedside to cost–benefit. Its combatants (and many of their defenders and detractors) are informed, articulate, and proud. The financial stakes are colossal. Reputations and fortunes are on the line. There is enough science and show-biz for every interest and taste. Somewhere, William Osler and H. L. Mencken are exchanging winks.

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