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A ready explanation is not apparent tor the discrepancy between the raised estradiol values Winter and co-workers initially obtained and the lower values from later collections. Two possible causes for differences are the prescribed medications, taken by approximately half of the patient group, and also any subsequent weight changes of the patients after their initial examination. Although our study was not longitudinal, we did find significantly higher estradiol levels compared with control subjects in patients with chronic coronary artery disease in addition to those patients with acute MI. Further follow-up data such as those presented by Winter and coworkers are needed for further understanding of the complex relationship between estradiol and ischemic heart disease.