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An enzyme called Carnitine Palmitoyltransferase I (CPT1), located on the outer mitochondrial membrane, attaches a molecule of L-carnitine to the long-chain fatty acid, creating an acylcarnitine complex

As discussed earlier, Koeth et al.'s study on gut microbiota-induced TMAO in stable patients undergoing cardiac evaluation showed significant dose-dependent associations between plasma L-carnitine levels and risks of coronary artery disease, peripheral artery disease, and overall CVD after correction for common CVD risk factors [18]

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