{"id":"b9a3bd47-a0bb-53ee-9063-3c62de4fa60f","stable_key":"ec174d5a-4903-5745-8646-df0e9d4265e8:fol-hope2-primary-outcome-null","predicate":"combined_b_vitamins_did_not_significantly_reduce_primary_composite","statement":"The primary cardiovascular death/MI/stroke composite occurred in 18.8% versus 19.8% (RR 0.95; 95% CI 0.84–1.07), without a significant treatment effect.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"e128e28e-53c3-5986-84ab-4e9c17216514","mechanism_event_label":"Improving homocysteine did not establish benefit for the primary clinical endpoint.","subject":{"id":"d322bfef-5135-599f-82e6-0aa58748dc8b","slug":"folic-acid","display_name":"Folic acid","entity_type_key":"small_molecule"},"object":{"id":"8f08bd23-f5e8-5787-b7b5-d6e1e26ed99c","slug":"major-cardiovascular-event-incidence","display_name":"Major cardiovascular event incidence","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"e128e28e-53c3-5986-84ab-4e9c17216514","stable_key":"ec174d5a-4903-5745-8646-df0e9d4265e8:fol-hope2-primary-outcome-null-event","event_type":"observed_intervention","label":"Improving homocysteine did not establish benefit for the primary clinical endpoint.","description":"The primary cardiovascular death/MI/stroke composite occurred in 18.8% versus 19.8% (RR 0.95; 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95% CI 0.84–1.07), without a significant treatment effect.\nCondition category: normal\nnutrient_topic: Folate and folic acid research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: Improving homocysteine did not establish benefit for the primary clinical endpoint.\norganism: Homo sapiens\ntissue_or_cell_type: Human blood or whole-person clinical endpoints\nexperimental_model: Randomized HOPE-2: 5522 adults at least 55 years old with vascular disease or diabetes, mean five years.\nlimitations: Distinct population, regimen and endpoint from CSPPT; this is an outcome boundary, not a contradiction to a biochemical reaction.\nexposure: Folic acid 2.5 mg, B6 50 mg and B12 1 mg/day together versus placebo; combined intervention, not isolated folate.\n[fol-hope2006] Homocysteine lowering with folic acid and B vitamins in vascular disease (2006). https://pubmed.ncbi.nlm.nih.gov/16531613/ DOI: 10.1056/nejmoa060900","model_system":"Randomized HOPE-2: 5522 adults at least 55 years old with vascular disease or diabetes, mean five years.","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [fol-hope2006] Homocysteine lowering with folic acid and B vitamins in vascular disease (2006). https://pubmed.ncbi.nlm.nih.gov/16531613/ DOI: 10.1056/nejmoa060900","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"f4ce1a62-9582-5f7a-84f5-a23d0e1bfc68","stable_key":"import-ec174d5a-4903-5745-8646-df0e9d4265e8","title":"Folate and folic acid: mechanisms, deficiency and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"e564d43989ece1006c95cd0748e9af6fe369074599a2eebba0a99ebff864b0dd","revision_id":"76674a33-b2a1-5e41-b71b-44399038ff7c","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}