25 april 2009-- Ranolazine may be effective in treating chronic angina, but does not appear to serve as a disease-modifying secondary preventive therapy, according to research published in the April 28 Journal of the American College of Cardiology.
Sean R. Wilson, M.D., of the Brigham and Women's Hospital in Boston, and colleagues analyzed data from 3,565 subjects with prior chronic angina who were enrolled in the Metabolic Efficiency With Ranolazine for Less Ischemia in Non-ST Elevation Acute Coronary Syndromes 36 (MERLIN-TIMI 36) trial, which compared ranolazine versus placebo in patients with acute coronary syndrome. Treated patients received intravenous ranolazine, then twice-daily oral doses until the end of the study. Follow-up lasted a median of 350 days.
Patients on ranolazine had a lower rate of recurrent ischemia (hazard ratio, 0.78). However, the treatment had no significant effect on risk of cardiovascular death or myocardial infarction. Ranolazine was also associated with reduction of worsening angina
"In this largest study of ranolazine in patients with established coronary artery disease, ranolazine was effective in reducing angina and recurrent ischemia in a substantially broader group of patients with angina than previously studied with a favorable overall profile of safety in a high-risk group of patients. Ranolazine is an option to be considered in the optimal medical therapy of patients with chronic angina," the authors conclude.
CV Therapeutics supported the MERLIN-TIMI 36 trial, and several authors disclosed financial relationships with the company; one author also disclosed arrangements with Sanofi-Aventis.