To the Editor, It appears that there is benefit with thrombolysis in ST-elevation myocardial infarction (STEMI) and hemodynamically unstable pulmonary embolism (PE) [1], [2]. In cardiac arrest the evidence is inconclusive although there is a robust biological rationale [1], [2]. TROICA (Thrombolysis for Out of Hospital Cardiac Arrest), a large double-blinded randomized placebo controlled trial showed no difference in 30-day mortality between thrombolysis and placebo group [3].