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Alcohol Consumption and Tissue-Type Plasminogen Activator-Reply

Paul M. Ridker, MD; Douglas E. Vaughan, MD; Meir J. Stampfer, MD; Robert J. Glynn, PhD; Charles H. Hennekens, MD
JAMA. 1995;273(18):1416-1417. doi:10.1001/jama.1995.03520420028018.
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In Reply.  —Our article reports observational data describing a potential mechanism for the cardioprotective effect of alcohol. Contrary to statements by Dr Lands and Dr Strand, we made no comments for or against alcohol use.We disagree with Lands and Strand that severe malnutrition and/or the presence of active hepatitis could account for the association between t-PA antigen level and alcohol consumption. These alternative hypotheses are implausible explanations of the observed data for several reasons.First, our study population solely comprised healthy US physicians, making severe protein malnutrition an unlikely confounder for the observed effect. In this regard, it should be noted that stratification by body mass index had no material effect on the association of t-PA antigen level and alcohol use, as indicated in Table 3 of the article. In fact, t-PA antigen levels were, if anything, lower among subjects with lower body mass rather than higher.Second, current


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