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Additionally, exposure of monocytes to homocysteine induces tissue factor (TF) expression (Khajuria and Houston, 2000), and exposure of endothelial cells to homocysteine increases TF expression (Fryer et al, 1993), and the activation of factor V to factor Va (Rodgers and Conn, 1990), thus favoring thrombin generation through initiation and propagation of the coagulation cascade