Zheng L, et al. - Researchers performed this nested case-control study from a prospective cohort design to ascertain the association of trimethylamine N-oxide (TMAO, has been recently reported as a risk factor for cardiovascular disease [CVD] in different clinical settings) with future risk of CVD in a population including 86 newly diagnosed CVD cases with a median follow-up period of 4.83 years and 86 matched controls. With the lowest quartile (<0.43 μmol/L) as reference, 2.735 and 2.544 were the estimated odds ratio (OR) for CVD for individuals with TMAO ≥1.89 μmol/L (Q4) and 1.05–1.89 μmol/L (Q3), respectively, as seen after multivariable adjustment. Findings revealed a positive link between TMAO and future risk of CVD in the community-based general population. Improved prediction of CVD, beyond traditional risk factors, was achieved with the addition of TMAO. TMAO was recommended to be considered as a potential novel preventive target in the management of low-risk CVD adults.