Review ArticleThe Intestinal Flora Metabolite Trimethylamine Oxide Is Inextricably Linked to Coronary Heart DiseaseZhang, Honghong MD1; Jing, Lele MD2; Zhai, Changlin MD2; Xiang, Qiannan MD2; Tian, Hongen MD2; Hu, Huilin MD2 Author Information 1Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University 2Affiliated Hospital of Jiaxing University: First Hospital of Jiaxing Corresponding Author: Huilin Hu MD, Affiliated Hospital of Jiaxing University: First Hospital of Jiaxing, Department of Cardiology, Affiliated Hospital of Jiaxing University, No.1882 Zhonghuan South Road, Jiaxing, 314000 Zhejiang People’s Republic of China (phone: +8615757396612; e-mail: [email protected]) Conflict of Interest: There are none. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Journal of Cardiovascular Pharmacology: November 18, 2022 - Volume - Issue - 10.1097/FJC.0000000000001387 doi: 10.1097/FJC.0000000000001387 Open PAP Metrics Abstract Atherosclerotic coronary heart disease is a common cardiovascular disease with high morbidity and mortality. In recent years, the incidence of coronary heart disease has gradually become younger, and biomarkers for predicting coronary heart disease have demonstrated-valuable clinical prospects. Several studies have established an association between coronary heart disease and intestinal flora metabolites, including trimethylamine oxide (TMAO), which has attracted widespread attention from researchers. Investigations have also shown that plasma levels of TMAO and its precursors can predict cardiovascular risk in humans; however, TMAO’s mechanism of action in causing coronary heart disease is not fully understood. This review examines TMAO’s generation, the mechanism through which it causes coronary heart disease, and the approaches used to treat TMAO-caused coronary heart disease to possible avenues for future research on coronary heart disease and find new concepts for the treatment of the condition. Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.