Issues raised by GUSTO.
The GUSTO trial raises several questions including the role of heparin in thrombolysis. The need for intravenous versus subcutaneous heparin with streptokinase (SK) has not been clarified in this trial. It is more likely that the superiority of tissue plasminogen activator (t-PA) was due to its accelerated administration rather than the accompanying heparin. Despite the improvement in survival, much is still to be achieved in obtaining optimal reperfusion rates.
White
H
H
Green Lane Hospital, Auckland, New Zealand.
D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D009203:Myocardial Infarction / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D013300:Streptokinase / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D006493:Heparin; D013300:Streptokinase; D010959:Tissue Plasminogen Activator