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The authors suggested that TMAO could be a useful biomarker for predicting plaque rupture in patients with a history of acute myocardial infarction [26]

AhmedHMMillerMNasirKMcEvoyJWHerringtonDBlumenthalRSet alPrimary low level of high-density lipoprotein cholesterol and risks of coronary heart disease, cardiovascular disease, and death: Results from the multi-ethnic study of atherosclerosis

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Rather, the majority of orally ingested l-carnitine in mice produced a previously unappreciated intermediary metabolite, -butyrobetaine (BB), in a gut microbiotadependent step that occurred at a site anatomically proximal to, and at a rate 1,000-fold higher than the rate of the formation of TMA (26)