Explaining discrepant mortality results between primary percutaneous transluminal coronary angioplasty and...

Differing relative outcomes in randomized versus registry studies comparing primary angioplasty with thrombolytic therapy for acute myocardial infarction suggest a clinical paradox. A predictive model based on differences in 5 treatment-related factors, including time to therapy, patency success, and angioplasty experience, suggests that relative outcomes may indeed vary, depending on the clinical setting in which therapy is given.