Coronary Thrombolysis: A Double-Edged Sword?
Authors: Jerry H. Gurwitz, Robert J. Goldberg, Joel M. Gore
Journal: Annals of Internal Medicine (1999)

Letters6 July 1999Coronary Thrombolysis: A Double-Edged Sword?Jerry H. Gurwitz, MD, Robert J. Goldberg, PhD, and Joel M. Gore, MDJerry H. Gurwitz, MDUniversity of Massachusetts Medical School; Worcester, MA 01655 (Gurwitz)University of Massachusetts Medical School; Worcester, MA 01655 (Goldberg)University of Massachusetts Medical School; Worcester, MA 01655 (Gore)Search for more papers by this author, Robert J. Goldberg, PhDUniversity of Massachusetts Medical School; Worcester, MA 01655 (Gurwitz)University of Massachusetts Medical School; Worcester, MA 01655 (Goldberg)University of Massachusetts Medical School; Worcester, MA 01655 (Gore)Search for more papers by this author, and Joel M. Gore, MDUniversity of Massachusetts Medical School; Worcester, MA 01655 (Gurwitz)University of Massachusetts Medical School; Worcester, MA 01655 (Goldberg)University of Massachusetts Medical School; Worcester, MA 01655 (Gore)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-1-199907060-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Coronary thrombolysis remains one of the most effective treatments for reducing mortality rates in the setting of acute myocardial infarction. Using the absolute risk reduction estimates presented by Dr. Kessler, 17 to 33 patients who appear to be having an acute myocardial infarction must be treated to save 1 life. Such numbers are generally considered favorable in comparison with other medical interventions. However, as Sackett and colleagues have written, the number needed to treat (NNT) is a measure with real meaning for clinicians in caring for populations but not for individual patients (1).Not every patient who is ...References1. Sackett DL, Richardson S, Rosenberg W, Haynes RB. Evidence-Based Medicine: How to Practice and Teach EBM. New York: Churchill Livingstone; 1997. Google Scholar2. Gurwitz JH, Goldberg RJ. Coronary thrombolysis for the elderly—is clinical practice really lagging behind evidence of benefit? JAMA. 1997;277:1723-4. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Massachusetts Medical School; Worcester, MA 01655 (Gurwitz)University of Massachusetts Medical School; Worcester, MA 01655 (Goldberg)University of Massachusetts Medical School; Worcester, MA 01655 (Gore) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRisk for Intracranial Hemorrhage after Tissue Plasminogen Activator Treatment for Acute Myocardial Infarction Jerry H. Gurwitz , Joel M. Gore , Robert J. Goldberg , Hal V. Barron , Timothy Breen , Amy Chen Rundle , Michael A. Sloan , William French , and William J. Rogers Coronary Thrombolysis: A Double-Edged Sword? Kenneth M. Kessler Metrics 6 July 1999Volume 131, Issue 1Page: 71KeywordsAbsolute risk reductionAcute myocardial infarctionDeath ratesDecision makingHemorrhageMedical risk factorsNumber needed to treatPopulation statistics ePublished: 15 August 2000 Issue Published: 6 July 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...