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Anti-anginal Drug Not Effective in Reducing Major Cardiac Events

t (cardiovascular death, heart attack, or severe recurrent ischemia) occurred in 18.7 percent of the patients in the ranolazine group compared with 19.2 percent of the patients in the placebo group. Failure of therapy (including cardiovascular death, heart attack, recurrent ischemia, hospitalization for new or worsening heart failure) occurred at similar rates in both groups. The risk of recurrent ischemia was reduced in the ranolazine group (13.9 percent) compared with the placebo group (16.1 percent). Symptomatic documented arrhythmias did not differ between the two groups. There was little difference in the total number of deaths between the ranolazine and placebo groups (172 vs. 175, respectively).

"The results of this robustly powered, randomized trial do not support the use of ranolazine for acute management of ACS or as disease-modifying therapy for secondary prevention of cardiovascular death or [heart attack]. However, our findings suggest a benefit of ranolazine as antianginal therapy in a substantially more broad population of patients with established ischemic heart disease than previously studied," the authors write. "These findings, together with the observed favorable overall profile of safety, provide additional evidence to guide the use of ranolazine as antianginal therapy in patients with chronic angina."

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