"I really love the apabetalone diagram that shows the six components that may contribute to the reduced MACE: complement pathway, coagulation pathway, vascular inflammation, vascular calcification, reverse cholesterol transport, metabolism."

Apabetalone hits so many different risk factors at once. A miracle pill? The apabetalone diagram linked to above on the Resverlogix web site reminds me of a figure from a paper (see below) from last year that I posted about called "A Conceptual Framework for Addressing Residual Atherosclerotic Cardiovascular Disease Risk in the Era of Precision Medicine."

It's a short but sweet paper that summarizes the current pharmacological toolbox for dealing with residual CVD risk. It references pretty much all of the recent CVOT achievements (in blue) and those pending (in green). Since publication of this paper, the omega-3 therapy Vascepa has proven itself in REDUCE-IT and the anti-inflammatory trials with methotrexate and colchicine have both flopped. Interestingly, apabetalone has been shown in various studies to elicit beneficial effects in most, if not all, of these categories: lipoproteins (HDL), inflammation, metabolism, platelets, coagulation. Plus, apabetalone has effects to reduce the complement pathway and vascular calcification. Wouldn't it be nice to see apabetalone added to the list(s) in a future version of this figure?

https://www.ncbi.nlm.nih.gov/pubmed/29643058

http://circ.ahajournals.org/content/early/2018/04/10/CIRCULATIONAHA.118.035289

Here is the text of the figure legend:

 "We propose five broad residual risk targets for secondary prevention of atherosclerotic cardiovascular disease and identify therapies either shown to be effective in large randomized trials (blue), or available for clinical use but not yet demonstrated to lower ASCVD risk (green). Precision medicine tools are proposed for each category (in many cases highly speculative) that could be used to guide selection among the potential therapies. Abbreviations - PCSK9: proprotein convertase subtilisin/kexin 9; LDL: low-density lipoprotein; HDL: high-density lipoprotein; TG: triglycerides; Lp(a): lipoprotein (a); hs-CRP: high-sensitivity C-reactive protein; DM: diabetes mellitus; Hb A1c: glycated hemoglobin; HOMA-IR: homeostatic model assessment for insulin resistance; BMI: body mass index; DAPT: Dual Antiplatelet Therapy;PARIS: Patterns of Non-Adherence to Anti-Platelet Regimen in Stented Patients; PRECISE DAPT: PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti Platelet Therapy; VTE: venous thromboembolism."