The future of an illusion.

wo reports (1,2) in this issue of the Journal describe the esults of the PROTECT–TIMI-30 (Randomized Trial to valuate the Relative Protection Against Post-Percutaneous oronary Intervention Microvascular Dysfunction, Ischemia, nd Inflammation Among Antiplatelet and Antithrombotic gents–Thrombolysis In Myocardial Infarction-30) study, a andomized trial whose primary outcome was unexpected. esults in science are hard to accept when they threaten stablished treatments (3) or violate dogma (4). How can the esults of the PROTECT–TIMI-30 trial be put into perpective? ackground. The PROTECT–TIMI-30 trial (1) was ponsored by the manufacturer of Integrilin (eptifibatide) to xplicate the results of REPLACE-2 (Randomized Evalution in PCI Linking Angiomax to Reduced Clinical vents) (5), a trial sponsored by the manufacturer of ngiomax (bivalirudin). The REPLACE-2 results sugested that bivalirudin monotherapy was not inferior to the ombination of heparin and platelet glycoprotein (GP) Ib/IIIa blockade during PCI (5).