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Circadian fluctuations in the efficacy of thrombolysis with streptokinase
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    Circadian fluctuations in the efficacy of streptokinase thrombolysis may be due to confounders

    Goldhammer et al (1) concluded from their retrospective study of patients treated with streptokinase that efficacy was higher in the early evening hours. There are at least two important confounding variables which may explain these observations. Firstly, it has been previously found that the time of day has an impact not only on the incidence, but also on the severity of AMI (2). Hence, the apparent reduction in effi...

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