Publication Name	World Journal of Cardiology
Manuscript ID	116780
Country	Italy

Category	Medicine, Research & Experimental
Manuscript Type	Review
Article Title	Gut microbiota-derived metabolite trimethylamine N-oxide in major adverse cardiovascular events: Mechanisms, risk assessment, and therapeutic strategies
Manuscript Source	Invited Manuscript
All Author List	Samuel Jaimez Alvarado, María Fernanda Flores Enciso, Amedeo Amedei and María Magdalena Aguirre García
Funding Agency and Grant Number	Funding Agency Grant Number Dirección General de Asuntos del Personal Académico-Programa de Apoyo a Proyectos de Investigación e Innovación Tecnológica IN219025 Consejo Nacional de Humanidades, Ciencias y Tecnologías CBF2023-2024-734
Corresponding Author	Amedeo Amedei, Full Professor, Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, Florence 50134, Tuscany, Italy. amedeo.amedei@unifi.it
Key Words	Trimethylamine N-oxide; Major adverse cardiovascular event; Atherosclerosis; Prognosis biomarker; 3,3-dimethyl-1-butanol; Fluoromethylcholine
Core Tip	Trimethylamine N-oxide (TMAO) is increasingly proposed as a prognostic biomarker and therapeutic target in cardiovascular disease, yet its clinical signal is strongly shaped by renal function and cardiometabolic comorbidity. We synthesize evidence linking TMAO to risk stratification, including incremental value beyond GRACE in acute coronary syndrome, highlight mechanistic advances from microbiota-targeted trimethylamine-lyase inhibitors, 3,3-dimethyl-1-butanol/fluoromethylcholine, that improve vascular and cardiac phenotypes in preclinical models, and outline a precision-nutrition framework that tailors TMAO-lowering strategies to individual producer metabotypes.
Citation	Jaimez Alvarado S, Flores Enciso MF, Amedei A, Aguirre García MM. Gut microbiota-derived metabolite trimethylamine N-oxide in major adverse cardiovascular events: Mechanisms, risk assessment, and therapeutic strategies. World J Cardiol 2026; In press

Received	2025-11-20 05:40
Peer-Review Started	2025-11-20 06:25
First Decision by Editorial Office Director	2025-12-09 08:40
Return for Revision	2025-12-09 08:40
Revised	2025-12-22 20:28
Publication Fee Transferred
Second Decision by Editor	2026-01-29 02:33
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-01-29 03:48
Articles in Press	2026-01-29 03:48
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1949-8462 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
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