Anti-ischemic effects and long-term survival during ranolazine monotherapy in patients with chronic severe angina

Abstract

In chronic angina patients, ranolazine monotherapy was well tolerated and increased exercise performance throughout its dosing interval at all doses studied without clinically meaningful hemodynamic effects. One-year survival was not lower than expected in this high-risk patient population. This metabolic approach to treating myocardial ischemia may offer a new therapeutic option for chronic angina patients.

Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial

“…ORBITA is comparable in size to the MARISA trial of single-agent antianginal therapy, which had 191 patients. 19 ORBITA only investigated PCI for stable angina and the results have no implications for patients undergoing PCI for acute coronary syndrome, including ST-elevation myocardial infarction for which morbidity and mortality advantages from PCI have been proven.30…”

“…Evidence from placebo-controlled randomised controlled trials shows that single antianginal therapies provide improvements in exercise time of 48-55 s. 18,19 The Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina (ORBITA) trial was designed to assess the effect of PCI versus placebo on exercise time in patients with stable ischaemic symptoms, Given the previous evidence, ORBITA was conservatively designed to be able to detect an effect size of 30 s.…”

The role of enhanced external counterpulsation in the treatment of angina and heart failure

“…Currently, in patients with angina who have exhausted other interventions or do not tolerate certain medications, EECP may be useful in improving symptoms; EECP is a Food and Drug Administrationapproved, class IIb-recommended treatment for refractory angina. However, results of the newer antiangina medication ranolazine have shown increased exercise duration and time to ST segment depression, and decreased angina frequency (27)(28)(29) versus placebo; thus, it is even more difficult to refer patients. EECP appears to be relatively safe in heart failure patients, but its efficacy is more nebulous; it is not recommended that patients undergo treatment only for heart failure.…”

Impact of ranolazine on ventricular arrhythmias – A systematic review

“…Its anti‐ischemic effects have been demonstrated by several clinical trials 3, 4, 5, 6. Additionally, it exerts modulatory effects on ion channels that have been similarly observed after chronic amiodarone use, such as reductions in I Kr , I Ks , late I Na , and I Ca 7.…”