Abstract
Background
Ranolazine (R), as add-on therapy in symptomatic patients with chronic stable coronary
artery disease (CAD), has been tested in randomized clinical studies. Aim of the study
was to assess in a meta-analysis the effects of R on angina, nitroglycerin consumption,
functional capacity, electrocardiographic signs of ischemia and hemodynamic parameters
in patients with chronic CAD.
Methods
Randomized trials assessing the effects of R compared to control on exercise duration,
time to onset of angina, time to 1 mm ST-segment depression, weekly nitroglycerin consumption and weekly angina frequency
were included in the analysis. The effects of R compared to control on heart rate
and blood pressure were also analyzed.
Results
Six trials enrolling 9223 patients were included in the analysis. At trough and peak
levels, R compared to control significantly improved exercise duration, time to onset
of angina and time to 1 mm ST-segment depression. Additionally, R compared to control significantly reduced
weekly angina frequency and weekly nitroglycerin consumption. Finally, R compared
to control did not significantly reduce supine systolic and diastolic blood pressure
as well as heart rate, standing heart rate and diastolic blood pressure, whereas it
modestly reduced standing systolic blood pressure. At sensitivity analysis, results
were not influenced by concomitant background therapy.
Conclusions
In symptomatic patients with chronic CAD, R, added to conventional therapy, effectively
reduces angina frequency and sublingual nitroglycerin consumption while prolonging
exercise duration as well as time to onset of ischemia and to onset of angina with
no substantial effects on blood pressure and heart rate.
Keywords
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Article info
Publication history
Published online: September 23, 2013
Accepted:
August 30,
2013
Received:
July 25,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
