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The usefulness of ranolazine for the treatment of refractory chronic stable angina pectoris as determined from a systematic review of randomized controlled trials.

Abstract
Despite the use of traditional antianginal medications (i.e., β blockers, calcium channel blockers, and nitrates) and revascularization therapies, symptoms of chronic stable angina pectoris (CSAP) persist in ≥25% of patients. The objective of this systematic review was to synthesize the available evidence from randomized controlled trials (RCTs) of ranolazine for the treatment of CSAP. We systematically searched the Cochrane Register of Controlled Trials, EMBASE, and MEDLINE through July 2013 for RCTs comparing ranolazine with placebo or antianginal medications administered as part of usual care for the management of CSAP. End points of interest included exercise stress test performance (duration, time to angina, and time to ST-segment depression), frequency of angina attacks/week, nitroglycerin use/week, and quality of life. We identified 7 RCTs (n = 3,317) of patients with CSAP due to coronary artery disease. Comparators included placebo, amlodipine, and atenolol. All but 1 trial showed a statistically significant improvement in all 3 exercise stress test parameters with ranolazine compared with placebo. Ranolazine also reduced angina frequency and nitroglycerin use compared with placebo. These findings were consistent whether or not patients were also prescribed traditional antianginal pharmacotherapy. In conclusion, ranolazine reduces anginal symptoms among patients with symptomatic CSAP despite their use of traditional antianginal medications.
AuthorsDavid Banon, Kristian B Filion, Talia Budlovsky, Caroline Franck, Mark J Eisenberg
JournalThe American journal of cardiology (Am J Cardiol) Vol. 113 Issue 6 Pg. 1075-82 (Mar 15 2014) ISSN: 1879-1913 [Electronic] United States
PMID24462341 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
CopyrightCopyright © 2014 Elsevier Inc. All rights reserved.
Chemical References
  • Acetanilides
  • Enzyme Inhibitors
  • Piperazines
  • Ranolazine
Topics
  • Acetanilides (therapeutic use)
  • Angina, Stable (drug therapy)
  • Chronic Disease
  • Enzyme Inhibitors (therapeutic use)
  • Humans
  • Piperazines (therapeutic use)
  • Randomized Controlled Trials as Topic
  • Ranolazine
  • Treatment Outcome

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