Not so long ago, therapies that led to a survival advantagein randomized trials were quickly endorsed and adopted. Thecosts required to achieve the clinical benefit were of onlyminimal interest to the primary decision makers physiciansseeking the best outcomes for their patients. And in that erathere would have been little controversy over whether tissueplasminogen activator (t-PA) is a more effective thrombolyticagent than intravenous streptokinase. Laboratory and clinicalstudies show that t-PA opens coronary arteries occluded by thrombusmore rapidly than streptokinase,1 and the Global Utilizationof Streptokinase and Tissue Plasminogen Activator for Occluded. . . [Full Text of this Article]
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