Scroll Up
Scroll Down
Play Play Play Play
Unregistered User
Click here if this is not your Personal Edition
 
Contact Us | Free E-Mail Updates | Journals | Register a colleague
 
 
Angina Pectoris/MI
 
   
 
SEARCH   
Doctor's Guide Free CME
Medline
Congress Resource Centre
 

 EXPLORE :
   Most Read News
 All News  All News
 All Webcasts / CME  All Webcasts / CME
 All Cases  All Cases
 Congress Resource Centre  Congress Resource Centre
 All Medical Resources  All Medical Resources
 Medical  My Personal Edition



Warning | Privacy

 

 
 Recent news - Angina Pectoris/MI
    Early invasive vs conservative treatment strategies in women and men with unstable angina and non-ST-segment elevation myocardial infarction: a meta-analysis - (JAMA)
    Invasive Treatment Appears Beneficial for Men and High-Risk Women With Certain Coronary Syndromes - (DGNews)
    Outcomes following coronary stenting in the era of bare-metal vs the era of drug-eluting stents - (JAMA)
    New Guidance Available for Cardiologists Treating Myocardial Bridging - (DGNews)
    TopAbstracts in Angina Pectoris/MI 06/25/2008 - (DGNews)

    News archive

     Recent webcasts/CME - Angina Pectoris/MI
      Optimizing Antiplatelet Therapy in the ACS Patient: The Intersection of Acute Coronary Syndromes and Oral Antiplatelet Therapy
      Use of Direct Thrombin Inhibitors for Treating Non-St-Segment Elevation Acute Coronary Syndromes in Special Patient Groups: Women, Diabetics, the Elderly, and Chronic Renal Insufficiency
      CRUSADE: Contemporary Evaluation and Management of 200,000 High-Risk NSTE-ACS Patients
      Understanding Chronic Ischemic Heart Disease Today
      Risk Stratification in Patients with Chronic Myocardial Ischemia

      Webcasts/CME archive

       Recent cases - Angina Pectoris/MI
        Diagnostic Uncertainty of Takotusbo Cardiomyopathy Presenting as Acute Myocardial Infarction in a Woman with Cardiovascular Risk Factors Hijacked at Gunpoint: A Case Report
        The Role of Intravascular Ultrasound in the Management of Spontaneous Coronary Artery Dissection
        Unusual Cause of Exercise-Induced Ventricular Fibrillation in a Well-Trained Adult Endurance Athlete: A Case Report
        Myocardial Ischemia in the Absence of Epicardial Coronary Artery Disease in Friedreich's Ataxia
        Double Rupture of Interventricular Septum and Free Wall of the Left Ventricle, as a Mechanical Complication of Acute Myocardial Infarction: A Case Report

        Cases archive
          




        my personal edition > angina pectoris/mi > news
        divider

          E-Mail this DGReview to a colleague

        DGReview


        Ranolazine Concurrent with Antianginals Reduces Frequency of Angina, Increases Exercise Capacity of Patients with Chronic Angina

        Journal of the American Medical Association (JAMA)

        01/21/2004
        By Joene Hendry


        Patients taking atenolol, amlodipine, or diltiazem for chronic angina experienced a reduction in angina frequency and nitroglycerine consumption, as well as an increased exercise capacity when also taking ranolazine, according to the findings of a 3-group parallel, double-blind, multicentre trial.

        "Ranolazine affords additional anti-anginal and anti-ischaemic efficacy in patients with severe chronic angina who remain symptomatic while taking standard doses of atenolol, amlodipine, or diltiazem, with minimal haemodynamic effects and without evident adverse long-term survival consequences over 1 to 2 years of therapy," writes Bernard R. Chaitman, MD, St. Louis University Health Sciences Center, Missouri, United States, and colleagues for the Combination Assessment of Ranolazine In Stable Angina (CARISA) Investigators.

        The researchers randomised 823 adults, with confirmed coronary artery disease and a minimum of 3 months of exertional angina, to receive twice daily ranolazine at either 750 mg or 1000 mg, or matching placebo for 12 weeks. The investigators determined change in treadmill exercise duration, time to onset of angina and ischaemia, nitroglycerine use, and the number of angina attacks over the course of treatment.

        Baseline data showed an average of 4.5 angina attacks per week and nearly as many nitroglycerine uses in the study group. With treatment, weekly angina attacks occurred a mean of 2.5 times in the 750 mg and 2.1 times in the 1000 mg ranolazine groups compared with 3.3 times in the placebo group, as well as a corresponding reduction in nitroglycerine use.

        Treadmill exercise at 12 hours after dosing (trough levels) increased from baseline by a pooled time of 115.6 seconds in the ranolazine groups compared with 91.7 seconds in the placebo group. Treadmill exercise at 4 hours after dosing (peak levels) increased from baseline by 99.4 seconds in the 750 mg and 91.5 seconds in the 1000 mg ranolazine groups compared with 65.4 seconds in the placebo group.

        Overall, adverse events occurred in 31.2% of the 750 mg and 32.7% of the 1000 mg ranolazine groups compared with 26.4% of the placebo group. The most common dose-related adverse effects included constipation, dizziness, nausea, and asthenia.

        The authors conclude that ranolazine therapy "may be particularly useful in patients who cannot tolerate the initiation or upward titration of currently available antianginal drugs because of their depressive effects on blood pressure and heart rate."

        JAMA 2004;291:309-316.

        E-Mail this DGReview to a colleague   To print, use this version






        All contents Copyright (c) 1995-2008 Doctor's Guide Publishing Limited. All rights reserved.



        The NTK initiative. Physicians helping physicians identify Need-To-Know science
           Feedback
        Please rate this article: Strongly DISAGREE...Strongly AGREE NTK logo
        Question 1 - Physicians need to become aware of this information as soon as possible. Question 2 - This information is likely to have an impact on the way physicians practice medicine.
        1
        2
        3
        4
        5
        6
        7
        Send