A drug's primary mechanism of action is not necessarily the same as the affected risk factors/endpoints. Apabetalone is an epigenetic drug and acts via bromodomain-2 selective BET inhibition. However, the beneficial effects of apabetalone on inflammation, apoAI/HDL, vascular calcification, complement pathway, coagulation pathway AND metabolism (i.e. endogenous glucose production and glucose absorption) are occuring due to the gene expression and protein expression changes that happen subsequent to BD2-selective BET inhibition. The beneficial effects of apabetalone on these aforementioned pathways is hypothesized to elicit reduction in 3-point MACE events.

BD2-Selective BET inhibition --> Gene Expression Changes --> Protein Changes --> Beneficial Cardiometabolic Pathway Changes --> MACE reduction