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EDITOR--Drenth et al suggest a policy of repeat thrombolysis if initial thrombolysis fails, but their arguments are flawed.
Firstly, they state that a routine policy of rescue angioplasty cannot be justified from a review of the literature, although they fail to mention that the trial by Ellis et al showed a significant reduction in the incidence of death or severe heart failure in the rescue angioplasty group compared with the conservative group.
Secondly, there are far fewer published data from randomised trials comparing the use of rescue thrombolysis with conservative treatment, yet the authors claim that these data support their current practice. …