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May 10, 1995

Alcohol Consumption and Tissue-Type Plasminogen Activator

Author Affiliations

National Institute on Alcohol Abuse and Alcoholism Bethesda, Md

JAMA. 1995;273(18):1416. doi:10.1001/jama.1995.03520420028016

To the Editor.  —The article by Dr Ridker and colleagues1 associates alcohol consumption with plasma levels of tissuetype plasminogen activator (t-PA) antigen. An accompanying Editorial2 illustrated the problem of complex situations and oversimplified interpretations. Weighing the benefits and risks of alcohol consumption is a serious issue for many Americans, and we should be careful that we do not amplify misunderstandings about underlying causes for the risks and benefits involved.The article failed to note that because fibrinolytic activity is influenced by levels of both the activator (t-PA) and its inhibitor (PAI-1), information on t-PA alone has little utility. The article also failed to acknowledge many prior reports of elevated t-PA associated with alcoholic cirrhosis. There was no evidence of the fibrinolytic status of the subjects or the cardioprotective effect of a 25% difference in plasma t-PA. Finally, the claim on page 932 provided a challenge to all scientists

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