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Guidelines for the management of acute coronary syndromes 2006

Andrew J Bezzina
Med J Aust 2006; 185 (5): 294-295.
Published online: 4 September 2006

To the Editor: The discussion of fibrinolysis in the recently published guidelines for the management of acute coronary syndromes 20061 is interesting. The recommendations clearly indicate that second-generation agents should be preferred to streptokinase in all circumstances. The guidelines reference the GUSTO-I trial data2 as the primary support for those recommendations. These data are, at best, debatable in terms of showing any benefit of front-loaded tissue plasminogen activator over streptokinase, and then only in limited circumstances (ie, patients aged less than 75 years with anterior infarcts and within 4 hours of the onset of symptoms).3,4

  • Andrew J Bezzina

  • Wollongong Hospital, Wollongong, NSW.


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