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In a double-blind, randomised controlled trial of 3680 adults with non-disabling cerebral infarction, subjects who received a combination of vitamin B 6 , vitamin B 12 , and folic acid showed moderate reduction in total homocysteine levels, but there was no effect on vascular outcomes (recurrent ischaemic stroke and coronary heart disease) during 2 years of follow-up.49 Probably a longer duration of treatment may be necessary or there may be other factors governing the clinical response