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For example, the ingestion of trimethylamine-containing (TMA-containing) dietary nutrients enriched in animal products such as choline, phosphatidylcholine, and l-carnitine can serve as precursor for the ultimate generation of an atherogenic metabolite, trimethylamine N -oxide (TMAO), via a metaorganismal pathway involving initial gut microbial formation of TMA, followed by host hepatic conversion of TMA into TMAO (48)

Though both the exposure and comparison cohorts were drawn from the same platform, which should not significantly impact the relative hazard rate ratios, results from the TriNetX platform need to be validated in other populations and platforms of EHRs

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