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Although a pre-specified meta-analysis of the SURPASS trials suggested no increase in MACE risk (Sattar et al., 2022), these trials were not primarily powered to adjudicate specific cardiovascular outcomes such as heart failure or atrial fibrillation, and patients with unstable cardiovascular conditions were often excluded

The most pronounced delay is observed with short-acting agents, while long-acting agents (including both oral and injectable) show attenuation of this effect over time due to tachyphylaxis [20,21,22]

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The absorption of L-carnitine after oral administration occurs partly via carrier-mediated transport and partly by passive diffusion