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Homocysteine is a relatively new screen for people at high risk for heart attack or stroke.

For example, it may be useful in patients who have a family history of coronary artery disease but no other known risk factors. However, its utility for this purpose is controversial because the role, if any, that homocysteine plays in the progression of cardiovascular disease (CVD) has not been established; homocysteine could be just a marker and not a cause of CVD.

There are, as of yet, no established guidelines for homocysteine testing, and routine screening, as is done for total cholesterol, is still being evaluated for the benefits. A physician may also order a homocysteine test to determine if a patient has B12 or folate deficiency.

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