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  • Title: Strokes and net clinical benefit.
    Author: White H.
    Journal: Aust N Z J Med; 1993 Dec; 23(6):737-8. PubMed ID: 8141714.
    Abstract:
    The need for careful assessment of stroke incidence in a trial comparing highly effective thrombolytic regimens was recognised in the design of the GUSTO trial. There was a gradation of stroke incidence from 1.22% in the streptokinase (SK) and subcutaneous heparin group, to 1.4% in the SK and intravenous heparin group, 1.55% in the tissue plasminogen activator (t-PA) and intravenous heparin group and 1.64% in the combination t-PA and SK group. The concept of net clinical benefit was developed to balance the adverse effect of stroke with the benefit of mortality reduction. On this analysis, the net clinical benefit favoured the accelerated t-PA regimen over the SK regimens.
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