Price disparities of thrombolytic agents and variability in complementary reperfusion therapies have a big impact on hospital costs of thrombolysis. Nine strategies combining 3 thrombolytic preparations (SK alone, SK + aspirin and rt-PA) and 3 strategies for the management of reocclusion are compared. Unit costs of cardiac catheterisation and surgery and direct cost of a hospital day were estimated from hospital accounts. The hypotheses concerning the frequency of interventions and length of stay were based on results in the literature and analysis of a series of 420 patients from 3 hospital centres. The average direct cost of hospitalisation per patient treated with streptokinase plus aspirin with a conservative approach was 22,500 FF. It increased by 15 p. 100 with delayed elective angioplasty and by 45 p. 100 with an aggressive reperfusion strategy. In a conservative protocol, hospital costs were 37 p. 100 higher when rt-PA was used instead of streptokinase. An rt-PA conservative management strategy was associated with a twenty times higher cost per additional survivor than that of streptokinase with aspirin.