The primary proposed mechanism of action for Meldonium (marketed as Mildronate®, not licensed by the FDA in the United States but produced and prescribed as a drug for treating patients with heart conditions such as angina, chronic heart failure, cardiomyopathy, and other cardiovascular disorders in several European countries) involves targeting de novo L-carnitine biosynthesis by inhibiting the enzyme gamma-butyrobetaine dioxygenase (BBOX) [47,48]. This evidence concerns the gene BBOX1 and congestive heart failure.