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In initial untargeted metabolomics studies (the large-scale study of small molecules, commonly known as metabolites, within cells, biofluids, tissues or organisms) in patients undergoing cardiac risk assessment, there were circulating levels of multiple polyol sweeteners, especially erythritol, were associated with incident (3 year) risk for major adverse cardiovascular events (MACE), which includes death or nonfatal myocardial infarction or stroke.  Subsequent study of physiological levels found erythritol enhanced platelet reactivity in vitro and thrombosis formation in vivo.  Another subsequent study found erythritol ingestion in healthy volunteers (n = 8) induced marked and sustained (>2 days) increases in plasma erythritol levels well above thresholds associated with heightened platelet reactivity and thrombosis potential in in vitro and in vivo studies.  The researchers concluded that findings reveal that erythritol is both associated with incident MACE risk...