Ninerafaxstat trihydrochloride (MB-1018972 trihydrochloride, IMB-101 trihydrochloride) acts as a competitive inhibitor of 3-ketoacyl-CoA thiolase (3-KAT) to partially suppress fatty acid oxidation. It is an orally active cardiac mitochondrial drug that restores myocardial energy homeostasis. Ninerafaxstat trihydrochloride regulates myocardial substrate utilization and improves cardiac efficiency. Ninerafaxstat trihydrochloride is also used in research of cardiovascular diseases.