Abstract
Streptokinase and tissue plasminogen activator are the two currently FDA approved agents for intravenous use to promote thrombolysis in acute myocardial infarction, Separate from the generic questions of patient selection criteria has been a sometimes acrimonious commercial issue-tinged debate concerning the relative risks and benefits to be expected following the use of one or the other of these two agents. Arguments center on questions of relative reperfusion rates, complication rates and clinical efficacy. In part the debate exists because: a) there is a dramatic price difference separating the two drugs; b) the market share (stakes) are substantial; and c) the ultimate arbiter, i.e. direct comparative data, is thus far limited.
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