GUSTO: The principal investigators respond to the criticism
In commentaries on the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) trial published in The Journal of Myocardial Ischemia this past fall and in the current issue, Drs. Elliot Rapaport, Peter Sleight/ and Norman Sharpe make various points with which we take exception. For example, we disagree with these commentators' assertion that the evidence from GUSTO does not support the 'open artery hypothesis.' Likewise, the contention that the benefits of recombinant tissue-type plasminogen activator over streptokinase were different in patients treated in the United States than in other countries is not bourne out by formal statistical testing of the GUSTO data. In this commentary, we respond to these and other points of dissension regarding the interpretation of the trial's results.
