The controversy over whether the more expensive rt-PA was clinically superior over streptokinase as a thrombolytic agent climaxed in the scientific press between 1988 and 1992. To end this controversy, the GUSTO trial (Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries) was set up, a head-to-head comparison between rt-PA and streptokinase. In the GUSTO-trial 41,021 heart attack patients were treated in 1,081 hospitals in 15 countries. Cardiologist Eric Topol of the Cleveland Clinic (USA), cardiologist/statistician Robert Califf of Duke University Medical Center (USA) and David Stump of Genentech coordinated the trial. In absolute figures the 30-day mortality rate in the rt-PA group was 1% lower (or in relative figures 14%) compared to the mortality in the streptokinase group. After the GUSTO studies, rt-PA became the thrombolytic drug of choice for most of the cardiologists in the Western world and would save the lives of many tens of thousands of heart attack patients.