With AUCs of 0.72 (95% CI, 0.61–0.83; p < 0.001) and 0.76 (95% CI, 0.66–0.85; p < 0.001), baseline TMAO levels tended to show better discriminatory ability for 90-day and 12-month major ischemic events compared with conventional risk factors, including hypertension, diabetes, atrial fibrillation, coronary heart disease, dyslipidemia, and prior stroke; the NIHSS scores and the NT-proBNP levels. This evidence concerns the gene NPPB and metabolic syndrome.