The May 15 issue of the Annals of Internal Medicine published a debate between critics of the GUSTO trial and the clinical investigators, followed by an independent commentary.

The investigators defended the design and interpretation of the trial, as well as the superior benefit of tPA compared to streptokinase. The critics concluded that any differences between tPA and SK in terms of efficacy or safety are small and less clinically important than the wider use and more rapid delivery of thrombolytic therapy with either drug.