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To the Editor: Dr Kastrati and colleagues¹ reported that among patients with acute myocardial infarction who were referred for percutaneous interventions, early administration of reteplase plus abciximab does not lead to a reduction of infarct size compared with abciximab alone. However, because the trial, which was conducted in Germany, used intravenous 500-mg aspirin as part of the initial treatment, the results may not be applicable to patients in the United States, where aspirin is only available in an oral form.

We are also concerned that the authors may not have accounted for some potential confounding factors that occurred after randomization, such as use of -blockers, an intervention that can reduce infarct size and improve myocardial viability.^2-3 Similarly, the authors did not report on the use of lipid-lowering therapy in the 2 groups throughout the study. This is especially important in light of recent evidence that statins provide early benefit in . . . [Full Text of this Article]

Anthony J. Busti, PharmD, BCPS
anthony.busti.@ttuhsc.edu

Kristen S. Marshall; Justin S. Hooper, PharmD
Texas Tech University Health Sciences Center
School of Pharmacy Dallas/Fort Worth Regional Campus
Dallas

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