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50 After 6 months, 63% patients from the treatment group and 60% patients from the placebo group did not have acute exacerbation, and the ratio decreased to 56% and 53% after 1-year follow-up, respectively

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In these studies, it was reported that high TMAO levels trigger 34-36 and exacerbate 37 vascular inflammation with proinflammatory effects, cause endothelial damage, 34 inhibit reverse cholesterol transport, 19 and increase the transformation of macrophages into foam cells 38 as well as platelet activation and thrombosis formation