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Editorial
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Volume 354:1629-1632 April 13, 2006 Number 15
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Homocysteine Trials — Clear Outcomes for Complex Reasons
Joseph Loscalzo, M.D., Ph.D.

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 by The Heart Outcomes Prevention Evaluation (HOPE) 2 Investigators
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 by Bønaa, K. H.
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In 1969, McCully first proposed that homocysteine causes atherosclerosis.1 His hypothesis was based on the finding of atherosclerotic plaque at autopsies of young people with homocystinuria. This hypothesis was later modified to include a broader population, positing that mild hyperhomocysteinemia caused by dietary deficiencies of the vitamin cofactors required for the metabolism of homocysteine — folic acid, vitamin B12, and vitamin B6 — is a risk factor for atherothrombosis. In developed countries, these vitamins are partially removed from foods during processing,2 and typical diets are rich in the precursor amino acid methionine (which is derived from animal proteins). These . . . [Full Text of this Article]


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From Brigham and Women's Hospital and Harvard Medical School — both in Boston.

This article was published at www.nejm.org on March 12, 2006.


Related Letters:

Homocysteine, B Vitamins, and Cardiovascular Disease
de Craen A. J.M., Stott D. J., Westendorp R. G.J., Khare A., Lopez M., Gogtay J., Quinlivan E. P., Gregory J. F. III, Refsum H., Smith A. D., Wang X., Demirtas H., Xu X., Tomlinson D. R., Lang D., Lewis M. J., Lonn E., the HOPE-2 Investigators , Bønaa K. H., Tverdal A., Ueland P. M.
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N Engl J Med 2006; 355:205-211, Jul 13, 2006. Correspondence

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