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The dosages of l-carnitine, acetyl-l-carnitine, and propionyl-l-carnitine were 23, 2, and 2 g/day, respectively, in the included studies, and the details were shown in Table 1, and part of the literature was retrieved from the previous study (7)

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Human plasma samples were analyzed using both NMR spectroscopy and LCMS/MS for -HB and AcAc quantification, while acetone was measured by GCMS

Of the participants, 34% had ASCVD (prior myocardial infarction [MI], stroke or peripheral artery disease), 20% had HF and 67% were at high cardiovascular risk (PREVENT score 20%) without existing cardiovascular disease