Regarding warfarin and thrombolysis my understanding is that warfarin is a relative contra-indication esp if INR > 3 or pt with higher risk of intracranial bleed (ie elderly).
Discussing with our local cardiologist they feel that primary angio is treatment of choice unless geographically impractical - when thrombolysis should be given.
As cardiologists regionally (and hopefully nationally) are taking more of an acute interest should we be pushing for more primary angio when available.
Regarding the mailing list, I have recently rejoined the list after several months out (because of my inbox becoming cluttered with junk). On returning there seems to be less coming through.
Samit Mitra
A&E Consultant, Middlesbrough
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