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. Author manuscript; available in PMC: 2019 Sep 1.
Published in final edited form as: J Thromb Haemost. 2018 Aug 9;16(9):1857–1872. doi: 10.1111/jth.14234

Figure 8. Summary scheme illustrating FMO3 involvement in TMAO generation, and enhanced thrombosis susceptibility.

Figure 8

The host hepatic enzyme FMO3 plays a critical role in the metaorganismal TMAO generation pathway, linking dietary sources of choline abundant in a Western diet and gut microbiota-dependent generation of TMA with TMAO generation. Results from the present and other studies reveal TMAO plays a direct role in augmenting platelet responsiveness to multiple agonists, promoting arterial endothelial cell activation, and enhancing susceptibility for thrombosis. Multiple clinical studies show TMAO is dose dependently associated with adverse thrombotic event risk and mortality.