Homocysteine in the prevention of ischemic heart disease, stroke and venous thromboembolism: therapeutic target or just another distraction?
Bibliographic record
Abstract
PURPOSE OF REVIEW: Homocysteine has been proposed as a potentially modifiable risk factor for arterial and venous vascular disease. This notion is supported by a large body of literature derived from observations in patients with rare inborn errors of metabolism associated with homocystinuria, experimental studies, which show that homocysteine promotes atherogenesis and thrombosis and epidemiological studies, which in general suggest a graded and independent relationship between homocysteine and atherothrombotic vascular risk. RECENT FINDINGS: The current review briefly summarizes observational studies with emphasis on new meta-analyses linking homocysteine to ischemic heart disease, stroke, and venous thromboembolism. These data support weak associations between homocysteine and vascular risk. A number of recent large randomized controlled trials failed to demonstrate benefit for homocysteine lowering with B vitamin supplements in the prevention of cardiovascular events and venous thrombosis. These studies, however, may have been insufficiently powered to detect modest but clinically important treatment benefits. Therefore, completion of ongoing large randomized trials is essential. SUMMARY: At present, the status of homocysteine as a target for intervention in the prevention of atherothrombotic arterial and venous disease is uncertain. Current evidence does not support the use of B vitamin supplements to reduce vascular risk. Ongoing large randomized trials will provide further clarity on this subject.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".