FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 332:1418-1424 May 25, 1995 Number 21 Next

	Full Text PDF Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article PubMed Citation

ABSTRACT

Background Patients with acute myocardial infarction who were treated with accelerated tissue plasminogen activator (t-PA) (given over a period of 11/2 hours rather than the conventional 3 hours, and with two thirds of the dose given in the first 30 minutes) had a 30-day mortality that was 15 percent lower than that of patients treated with streptokinase in the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) study. This was equivalent to an absolute decrease of 1 percent in 30-day mortality. We sought to assess whether the use of t-PA, as compared with streptokinase, is cost effective.

Methods Our primary, or base-case, analysis of cost effectiveness used data from the GUSTO study and life expectancy projected on the basis of the records of survivors of myocardial infarction in the Duke Cardiovascular Disease Database. In the primary analysis, we assumed that there were no additional treatment costs due to the use of t-PA after the first year and that the comparative survival benefit of t-PA was still evident one year after enrollment.

Results One year after enrollment, patients who received t-PA had both higher costs ($2,845) and a higher survival rate (an increase of 1.1 percent, or 11 per 1000 patients treated) than streptokinase-treated patients. On the basis of the projected life expectancy of each treatment group, the incremental cost-effectiveness ratio — with both future costs and benefits discounted at 5 percent per year — was $32,678 per year of life saved. The use of t-PA was least cost effective in younger patients and most cost effective in older patients. At all ages, the use of t-PA in patients with anterior infarctions yielded more favorable cost-effectiveness values. In our secondary analyses, the cost-effectiveness values were most sensitive to a lowering of the projected long-term survival benefits of t-PA and to moderate or greater increases in the projected medical costs for patients in the t-PA group after the first year. In contrast, our results were not sensitive to even very unfavorable assumptions about the additional costs associated with the higher rate of disabling stroke that was noted in patients treated with t-PA in the GUSTO study.

Conclusions The cost effectiveness of treatment with accelerated t-PA rather than streptokinase compares favorably with that of other therapies whose added medical benefit for dollars spent is judged by society to be worthwhile.

Source Information

From the Economic and Quality of Life Coordinating Center (D.B.M., C.L.N., N.C.-C., J.D.K.) and the Clinical Trials Coordinating Center (R.M.C., K.L.L.), Division of Cardiology, Department of Medicine, and the Division of Biometry, Department of Community and Family Medicine (K.L.L., F.E.H.), Duke University Medical Center, Durham, N.C.; the Division of Health Services Research, Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, Calif. (M.A.H.); the Department of Medicine, University of Toronto, and the Institute for Clinical Evaluative Sciences, Toronto (C.D.N.); the Department of Medicine, University of Alberta, Edmonton (P.W.A.); Tel Aviv Sorasky University Medical Center, Tel Aviv, Israel (G.B.); the Cardiology Department, Green Lane Hospital, Auckland, New Zealand (H.W.); Erasmus University, Rotterdam, the Netherlands (M.L.S.); the National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia (J.S.); and the Department of Cardiology, Cleveland Clinic, Cleveland (E.J.T.).

Address reprint requests to Dr. Mark at P.O. Box 3485, Duke University Medical Center, Durham, NC 27710.

Full Text of this Article

Related Letters:

Is the Use of t-PA as Compared with Streptokinase Cost Effective?
Rose E. A., Armentano R., Favaloro R. G., Mark D. B.
Extract | Full Text  
N Engl J Med 1995; 333:1009-1010, Oct 12, 1995. Correspondence

This article has been cited by other articles:

• Messori, A., Trippoli, S., Bonacchi, M., Sani, G. (2009). Left ventricular assist device as destination therapy: application of the payment-by-results approach for the device reimbursement.. J. Thorac. Cardiovasc. Surg. 138: 480-485 [Abstract] [Full Text]  
• Levy, W. C., Mozaffarian, D., Linker, D. T., Kenyon, K. W., Cleland, J. G.F., Komajda, M., Remme, W. J., Torp-Pedersen, C., Metra, M., Poole-Wilson, P. A., on behalf of the COMET Investigators, (2009). Years-needed-to-treat to add 1 year of life: a new metric to estimate treatment effects in randomized trials. Eur J Heart Fail 11: 256-263 [Abstract] [Full Text]  
• Bravo Vergel, Y., Sculpher, M. (2008). Quality-adjusted life years. PN 8: 175-182 [Abstract] [Full Text]  
• Chan, P. S., Nallamothu, B. K., Gurm, H. S., Hayward, R. A., Vijan, S. (2007). Incremental Benefit and Cost-Effectiveness of High-Dose Statin Therapy in High-Risk Patients With Coronary Artery Disease. Circulation 115: 2398-2409 [Abstract] [Full Text]  
• Fang, C.T., Chang, Y.Y., Hsu, H.M., Twu, S.J., Chen, K.T., Lin, C.C., Huang, L.Y.L., Chen, M.Y., Hwang, J.S., Wang, J.D., Chuang, C.Y. (2007). Life expectancy of patients with newly-diagnosed HIV infection in the era of highly active antiretroviral therapy. QJM 100: 97-105 [Abstract] [Full Text]  
• Perlroth, D. J., Sanders, G. D., Gould, M. K. (2007). Effectiveness and Cost-effectiveness of Thrombolysis in Submassive Pulmonary Embolism. Arch Intern Med 167: 74-80 [Abstract] [Full Text]  
• Mark, D. B., Nelson, C. L., Anstrom, K. J., Al-Khatib, S. M., Tsiatis, A. A., Cowper, P. A., Clapp-Channing, N. E., Davidson-Ray, L., Poole, J. E., Johnson, G., Anderson, J., Lee, K. L., Bardy, G. H., for the SCD-HeFT Investigators, (2006). Cost-Effectiveness of Defibrillator Therapy or Amiodarone in Chronic Stable Heart Failure: Results From the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). Circulation 114: 135-142 [Abstract] [Full Text]  
• Singaroyan, R., Seed, C. A., Egdell, R. M. (2006). Is a target culture in health care always compatible with efficient use of resources? A cost-effectiveness analysis of an intervention to achieve thrombolysis targets. J Public Health (Oxf) 28: 31-34 [Abstract] [Full Text]  
• Feldman, A. M., de Lissovoy, G., Bristow, M. R., Saxon, L. A., De Marco, T., Kass, D. A., Boehmer, J., Singh, S., Whellan, D. J., Carson, P., Boscoe, A., Baker, T. M., Gunderman, M. R. (2005). Cost Effectiveness of Cardiac Resynchronization Therapy in the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Trial. J Am Coll Cardiol 46: 2311-2321 [Abstract] [Full Text]  
• King, J. T. Jr., Tsevat, J., Lave, J. R., Roberts, M. S. (2005). Willingness to Pay for a Quality-Adjusted Life Year: Implications for Societal Health Care Resource Allocation. Med Decis Making 25: 667-677 [Abstract]  
• Rinfret, S., Cohen, D. J., Lamas, G. A., Fleischmann, K. E., Weinstein, M. C., Orav, J., Schron, E., Lee, K. L., Goldman, L. (2005). Cost-Effectiveness of Dual-Chamber Pacing Compared With Ventricular Pacing for Sinus Node Dysfunction. Circulation 111: 165-172 [Abstract] [Full Text]  
• Cohen, D. J., Murphy, S. A., Baim, D. S., Lavelle, T. A., Berezin, R. H., Cutlip, D. E., Ho, K. K.L., Kuntz, R. E., the SAFER Trial Investigators, (2004). Cost-effectiveness of distal embolic protection for patients undergoing percutaneous intervention of saphenous vein bypass grafts: Results from the SAFER trial. J Am Coll Cardiol 44: 1801-1808 [Abstract] [Full Text]  
• Qureshi, A. I., Suri, M. F. K., Kirmani, J. F., Divani, A. A. (2004). The Relative Impact of Inadequate Primary and Secondary Prevention on Cardiovascular Mortality in the United States. Stroke 35: 2346-2350 [Abstract] [Full Text]  
• Menon, V., Harrington, R. A., Hochman, J. S., Cannon, C. P., Goodman, S. D., Wilcox, R. G., Schunemann, H. J., Ohman, E. M. (2004). Thrombolysis and Adjunctive Therapy in Acute Myocardial Infarction: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126: 549S-575S [Abstract] [Full Text]  
• Prystowsky, E. N. (2004). Primary Prevention of Sudden Cardiac Death: The Time of Your Life. Circulation 109: 1073-1075 [Full Text]  
• Le May, M. R., Davies, R. F., Labinaz, M., Sherrard, H., Marquis, J.-F., Laramee, L. A., O'Brien, E. R., Williams, W. L., Beanlands, R. S., Nichol, G., Higginson, L. A. (2003). Hospitalization Costs of Primary Stenting Versus Thrombolysis in Acute Myocardial Infarction: Cost Analysis of the Canadian STAT Study. Circulation 108: 2624-2630 [Abstract] [Full Text]  
• Stahl, J. E., Furie, K. L., Gleason, S., Gazelle, G. S. (2003). Stroke: Effect of Implementing an Evaluation and Treatment Protocol Compliant with NINDS Recommendations. Radiology 228: 659-668 [Abstract] [Full Text]  
• Cleland, J.G.F., Takala, A., Apajasalo, M., Zethraeus, N., Kobelt, G. (2003). Intravenous levosimendan treatment is cost-effective compared with dobutamine in severe low-output heart failure: an analysis based on the international LIDO trial. Eur J Heart Fail 5: 101-108 [Abstract] [Full Text]  
• Donaldson, C., Currie, G., Mitton, C. (2002). Cost effectiveness analysis in health care: contraindications. BMJ 325: 891-894 [Full Text]  
• Mahoney, E. M., Jurkovitz, C. T., Chu, H., Becker, E. R., Culler, S., Kosinski, A. S., Robertson, D. H., Alexander, C., Nag, S., Cook, J. R., Demopoulos, L. A., DiBattiste, P. M., Cannon, C. P., Weintraub, W. S., for the TACTICS-TIMI 18 Investigators, (2002). Cost and Cost-effectiveness of an Early Invasive vs Conservative Strategy for the Treatment of Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction. JAMA 288: 1851-1858 [Abstract] [Full Text]  
• Baker, W. F. Jr (2002). Thrombolytic Therapy. CLIN APPL THROMB HEMOST 8: 291-314  
• (2002). Understanding Costs and Cost-Effectiveness in Critical Care . Report from the Second American Thoracic Society Workshop on Outcomes Research. Am. J. Respir. Crit. Care Med. 165: 540-550 [Abstract] [Full Text]  
• Mark, D. B., Lee, T. H. (2002). Conservative Management of Acute Coronary Syndrome: Cheaper and Better for You?. Circulation 105: 666-668 [Full Text]  
• Brown, R.E., Henderson, R.A., Koster, D., Hutton, J., Simoons, M.L. (2002). Cost effectiveness of eptifibatide in acute coronary syndromes. An economic analysis of Western European patients enrolled in the PURSUIT trial. Eur Heart J 23: 50-58 [Abstract] [Full Text]  
• Giri, S., Shaw, L. J., Murthy, D. R., Travin, M. I., Miller, D. D., Hachamovitch, R., Borges-Neto, S., Berman, D. S., Waters, D. D., Heller, G. V. (2002). Impact of Diabetes on the Risk Stratification Using Stress Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging in Patients With Symptoms Suggestive of Coronary Artery Disease. Circulation 105: 32-40 [Abstract] [Full Text]  
• Cannon, C. P., Battler, A., Brindis, R. G., Cox, J. L., Ellis, S. G., Every, N. R., Flaherty, J. T., Harrington, R. A., Krumholz, H. M., Simoons, M. L., Van De Werf, F. J. J., Weintraub, W. S., Mitchell, K. R., Morrisson, S. L., Brindis, R. G., Anderson, H. V., Cannom, D. S., Chitwood, W. R. Jr, Cigarroa, J. E., Collins-Nakai, R. L., Ellis, S. G., Gibbons, R. J., Grover, F. L., Heidenreich, P. A., Khandheria, B. K., Knoebel, S. B., Krumholz, H. L., Malenka, D. J., Mark, D. B., Mckay, C. R., Passamani, E. R., Radford, M. J., Riner, R. N., Schwartz, J. B., Shaw, R. E., Shemin, R. J., Van Fossen, D. B., Verrier, E. D., Watkins, M. W., Phoubandith, D. R., Furnelli, T. (2001). American College of Cardiology key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes: A report of the American College of Cardiology Task Force on Clinical Data Standards (Acute Coronary Syndromes Writing Committee) Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, American College of Emergency Physicians, American Heart Association, Cardiac Society of Australia & New Zealand, National Heart Foundation of Australia, Society for Cardiac Angiography and Interventions, and the Taiwan Society of Cardiology. J Am Coll Cardiol 38: 2114-2130 [Full Text]  
• Simon, G. E., Katon, W. J., VonKorff, M., Unutzer, J., Lin, E. H.B., Walker, E. A., Bush, T., Rutter, C., Ludman, E. (2001). Cost-Effectiveness of a Collaborative Care Program for Primary Care Patients With Persistent Depression. Am. J. Psychiatry 158: 1638-1644 [Abstract] [Full Text]  
• Lee, G. M., Fleisher, G. R., Harper, M. B. (2001). Management of Febrile Children in the Age of the Conjugate Pneumococcal Vaccine: A Cost-Effectiveness Analysis. Pediatrics 108: 835-844 [Abstract] [Full Text]  
• McMahon, P. M., Bosch, J. L., Gleason, S., Halpern, E. F., Lester, J. S., Gazelle, G. S. (2001). Cost-Effectiveness of Colorectal Cancer Screening. Radiology 219: 44-50 [Abstract] [Full Text]  
• Simon, G. E., Manning, W. G., Katzelnick, D. J., Pearson, S. D., Henk, H. J., Helstad, C. P. (2001). Cost-effectiveness of Systematic Depression Treatment for High Utilizers of General Medical Care. Arch Gen Psychiatry 58: 181-187 [Abstract] [Full Text]  
• Ohman, E. M., Harrington, R. A., Cannon, C. P., Agnelli, G., Cairns, J. A., Kennedy, J.W. (2001). Intravenous Thrombolysis in Acute Myocardial Infarction. Chest 119 : 253S-277S [Full Text]  
• Mayer, S. A., Copeland, D., Bernardini, G. L., Boden-Albala, B., Lennihan, L., Kossoff, S., Sacco, R. L. (2000). Cost and Outcome of Mechanical Ventilation for Life-Threatening Stroke. Stroke 31: 2346-2353 [Abstract] [Full Text]  
• Hirth, R. A., Chernew, M. E., Miller, E., Fendrick, A. M., Weissert, W. G. (2000). Willingness to Pay for a Quality-adjusted Life Year: In Search of a Standard. Med Decis Making 20: 332-342 [Abstract]  
• Smith, K. J., Roberts, M. S. (2000). The Cost-Effectiveness of Sildenafil. ANN INTERN MED 132: 933-937 [Abstract] [Full Text]  
• McGarvey, M. R. (2000). Tough Choices: The Cost-Effectiveness of Sildenafil. ANN INTERN MED 132: 994-995 [Full Text]  
• Elliott, W. J., Weir, D. R., Black, H. R. (2000). Cost-effectiveness of the Lower Treatment Goal (of JNC VI) for Diabetic Hypertensive Patients. Arch Intern Med 160: 1277-1283 [Abstract] [Full Text]  
• Harrington, R.A., Simoons, M.L. (2000). What have we learned from the recent large trials in acute coronary syndromes without ST-segment elevation?. Eur Heart J 21: 702-704  
• Newby, L. K., Eisenstein, E. L., Califf, R. M., Thompson, T. D., Nelson, C. L., Peterson, E. D., Armstrong, P. W., Van de Werf, F., White, H. D., Topol, E. J., Mark, D. B. (2000). Cost Effectiveness of Early Discharge after Uncomplicated Acute Myocardial Infarction. NEJM 342: 749-755 [Abstract] [Full Text]  
• Tanne, D., Gorman, M. J., Bates, V. E., Kasner, S. E., Scott, P., Verro, P., Binder, J. R., Dayno, J. M., Schultz, L. R., Levine, S. R. (2000). Intravenous Tissue Plasminogen Activator for Acute Ischemic Stroke in Patients Aged 80 Years and Older : The tPA Stroke Survey Experience. Stroke 31: 370-375 [Abstract] [Full Text]  
• Mark, D. B., Harrington, R. A., Lincoff, A. M., Califf, R. M., Nelson, C. L., Tsiatis, A. A., Buell, H., Mahaffey, K. W., Davidson-Ray, L., Topol, E. J. (2000). Cost-Effectiveness of Platelet Glycoprotein IIb/IIIa Inhibition With Eptifibatide in Patients With Non-ST-Elevation Acute Coronary Syndromes. Circulation 101: 366-371 [Abstract] [Full Text]  
• O'Brien, B., Levine, M., Willan, A., Goeree, R., Haley, S., Blackhouse, G., Gent, M. (1999). Economic Evaluation of Outpatient Treatment With Low-Molecular-Weight Heparin for Proximal Vein Thrombosis. Arch Intern Med 159: 2298-2304 [Abstract] [Full Text]  
• Reed, G. L., Houng, A. K., Liu, L., Parhami-Seren, B., Matsueda, L. H., Wang, S., Hedstrom, L. (1999). A catalytic switch and the conversion of streptokinase to a fibrin-targeted plasminogen activator. Proc. Natl. Acad. Sci. USA 96: 8879-8883 [Abstract] [Full Text]  
• Weinstein, M. C. (1999). High-Priced Technology Can Be Good Value for Money. ANN INTERN MED 130: 857-858 [Full Text]  
• Neumann, P. J., Hermann, R. C., Kuntz, K. M., Araki, S. S., Duff, S. B., Leon, J., Berenbaum, P. A., Goldman, P. A., Williams, L. W., Weinstein, M. C. (1999). Cost-effectiveness of donepezil in the treatment of mild or moderate Alzheimer's disease. Neurology 52: 1138-1138 [Abstract] [Full Text]  
• Shaw, L. J., Hachamovitch, R., Berman, D. S., Marwick, T. H., Lauer, M. S., Heller, G. V., Iskandrian, A. E., Kesler, K. L., Travin, M. I., Lewin, H. C., Hendel, R. C., Borges-Neto, S., Miller, D. D., for the Economics of Noninvasive Diagnosis (END) M, (1999). The economic consequences of available diagnostic and prognostic strategies for the evaluation of stable angina patients: an observational assessment of the value of precatheterization ischemia. J Am Coll Cardiol 33: 661-669 [Abstract] [Full Text]  
• Tung, C. Y., Granger, C. B., Sloan, M. A., Topol, E. J., Knight, J. D., Weaver, W. D., Mahaffey, K. W., White, H., Clapp-Channing, N., Simoons, M. L., Gore, J. M., Califf, R. M., Mark, D. B. (1999). Effects of Stroke on Medical Resource Use and Costs in Acute Myocardial Infarction. Circulation 99: 370-376 [Abstract] [Full Text]  
• Waugh, J. M., Yuksel, E., Li, J., Kuo, M. D., Kattash, M., Saxena, R., Geske, R., Thung, S. N., Shenaq, S. M., Woo, S. L. C. (1999). Local Overexpression of Thrombomodulin for In Vivo Prevention of Arterial Thrombosis in a Rabbit Model. Circ. Res. 84: 84-92 [Abstract] [Full Text]  
• Cohen, A. B. (1998). Commentary. Med Care Res Rev 55: 289-297  
• Wright, J. C., Weinstein, M. C. (1998). Gains in Life Expectancy from Medical Interventions -- Standardizing Data on Outcomes. NEJM 339: 380-386 [Abstract] [Full Text]  
• (1998). Integrating Economic Analysis Into Cancer Clinical Trials: the National Cancer Institute-American Society of Clinical Oncology Economics Workbook. J Natl Cancer Inst Monogr 1998: 1-28 [Full Text]  
• White, H. D., Van de Werf, F. J. J. (1998). Thrombolysis for Acute Myocardial Infarction. Circulation 97: 1632-1646 [Abstract] [Full Text]  
• Drummond, M. F. (1998). Experimental versus Observational Data in the Economic Evaluation of Pharmaceuticals. Med Decis Making 18: S12-S18  
• Lipscomb, J., Ancukiewicz, M., Parmigiani, G., Hasselblad, V., Samsa, G., Matchar, D. B. (1998). Predicting the Cost of Illness: A Comparison of Alternative Models Applied to Stroke. Med Decis Making 18: S39-S56 [Abstract]  
• Hachamovitch, R., Berman, D. S., Shaw, L. J., Kiat, H., Cohen, I., Cabico, J. A., Friedman, J., Diamond, G. A. (1998). Incremental Prognostic Value of Myocardial Perfusion Single Photon Emission Computed Tomography for the Prediction of Cardiac Death : Differential Stratification for Risk of Cardiac Death and Myocardial Infarction. Circulation 97: 535-543 [Abstract] [Full Text]  
• GLASZIOU, P. (1998). Using cost-effectiveness for subsidy decisions. Heart 79: 7-8 [Full Text]  
• Scharfstein, J. A., Paltiel, A. D., Freedberg, K. A. (1997). The Cost-Effectiveness of Fluconazole Prophylaxis against Primary Systemic Fungal Infections in AIDS Patients. Med Decis Making 17: 373-381 [Abstract]  
• Stanek, E. J., Cheng, J. W.M., Peeples, P. J., Simko, R. J., Spinler, S. A. (1997). Patient Preferences for Thrombolytic Therapy in Acute Myocardial Infarction. Med Decis Making 17: 464-471 [Abstract]  
• Fryback, D. G., Lawrence, W. F. JR (1997). Dollars May Not Buy as Many QALYs as We Think:: A Problem with Defining Quality-of-life Adjustments. Med Decis Making 17: 276-284 [Abstract]  
• O'Brien, B. J., Heyland, D., Richardson, W. S., Levine, M., Drummond, M. F., for the Evidence-Based Medicine Working Group, (1997). Users' Guides to the Medical Literature: XIII. How to Use an Article on Economic Analysis of Clinical Practice B. What Are the Results and Will They Help Me in Caring for My Patients?. JAMA 277: 1802-1806 [Abstract]  
• Drummond, M. F., Richardson, W. S., O'Brien, B. J., Levine, M., Heyland, D. (1997). Users' Guides to the Medical Literature: XIII. How to Use an Article on Economic Analysis of Clinical Practice A. Are the Results of the Study Valid?. JAMA 277: 1552-1557 [Abstract]  
• Collins, R., Peto, R., Baigent, C., Sleight, P. (1997). Aspirin, Heparin, and Fibrinolytic Therapy in Suspected Acute Myocardial Infarction. NEJM 336: 847-860 [Full Text]  
• Topol, E. J., Califf, R. M., Van de Werf, F., Simoons, M., Hampton, J., Lee, K. L., White, H., Simes, J., Armstrong, P. W. (1997). Perspectives on Large-Scale Cardiovascular Clinical Trials for the New Millennium. Circulation 95: 1072-1082 [Full Text]  
• Johannesson, M., Jonsson, B., Kjekshus, J., Olsson, A. G., Pedersen, T. R., Wedel, H., The Scandinavian Simvastatin Survival Study Group, (1997). Cost Effectiveness of Simvastatin Treatment to Lower Cholesterol Levels in Patients with Coronary Heart Disease. NEJM 336: 332-336 [Abstract] [Full Text]  
• Freemantle, N., Drummond, M. (1997). Should Clinical Trials With Concurrent Economic Analyses Be Blinded?. JAMA 277: 63-64 [Abstract]  
• Derdeyn, C. P., Powers, W. J. (1996). Cost-Effectiveness of Screening for Asymptomatic Carotid Atherosclerotic Disease. Stroke 27: 1944-1950 [Abstract] [Full Text]  
• White, H. D., Barbash, G. I., Califf, R. M., Simes, R. J., Granger, C. B., Weaver, W. D., Kleiman, N. S., Aylward, P. E., Gore, J. M., Vahanian, A., Lee, K. L., Ross, A. M., Topol, E. J. (1996). Age and Outcome With Contemporary Thrombolytic Therapy: Results From the GUSTO-I Trial. Circulation 94: 1826-1833 [Abstract] [Full Text]  
• Califf, R. M., White, H. D., Van de Werf, F., Sadowski, Z., Armstrong, P. W., Vahanian, A., Simoons, M. L., Simes, R. J., Lee, K. L., Topol, E. J. (1996). One-Year Results From the Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries (GUSTO-I) Trial. Circulation 94: 1233-1238 [Abstract] [Full Text]  
• Gore, J. M., Dalen, J. E. (1996). Cardiovascular Disease. JAMA 275: 1797-1798 [Abstract]  
• Rose, E. A., Armentano, R., Favaloro, R. G., Mark, D. B. (1995). Is the Use of t-PA as Compared with Streptokinase Cost Effective?. NEJM 333: 1009-1010 [Full Text]  
• (1995). Cost Effectiveness of t-PA, Streptokinase. Journal Watch Cardiology 1995: 7-7 [Full Text]  
• Lee, T. H. (1995). Cost Effectiveness of Tissue Plasminogen Activator. NEJM 332: 1443-1444 [Full Text]