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Importantly, bempedoic acid is an inactive prodrug and requires activation by coenzyme A (CoA) with long-chain acyl-CoA 1 synthetase (ACSVL1), and the entire process takes place in the liver rather than in skeletal muscles, which from the very beginning indicated that it may be a very effective agent for statin-intolerant patients [216]

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The participants diets were supplemented with either 1 g of LC-L-tartrate and 3 g of leucine per day (LC group) or 4 g of leucine per day as a placebo (PLA group), in a double-blind fashion