Antianginal Efficacy and Tolerability of Ranolazine as an Add-on Drug to Concomitant Medications Primarily Metoprolol in Chronic Stable Angina Patients: A Prospective, Open-Label Study

Abstract

Objective: To evaluate the efficacy and tolerability of ranolazine as an add-on drug in chronic stable angina patients and the impact of ranolazine on the quality of life in chronic stable angina patients receiving other antianginal medications.

Materials and methods: It was a prospective, open-label, hospital-based study involving 144 patients with chronic stable angina. First group received either metoprolol 12.5 or 25 mg/day or other antianginal medications; if the symptoms persist, the dose of metoprolol was increased to 50 mg/day, and to the second group, ranolazine 500 mg BD or 1 g OD was added along with metoprolol or others if the anginal attacks were not subsiding. The patients were followed up to 6 months with electrocardiography, treadmill test, and quality of life questionnaire. Adverse events were recorded at each visit during the study.

Results: There was a statistically significant reduction in weekly anginal frequency (P < 0.001) and improvement in an exercise tolerance in both the groups, but more in the ranolazine group. Adverse events reported were mild, infrequent.

Conclusion: Ranolazine is could be used as an add-on drug in chronic angina patients not improved with metoprolol or antianginal medications.

Keywords: Coronary artery disease; exercise tolerance; percutaneous intervention; quality of life; ranolazine.

Figure 1

Flow of participants through the trial

Figure 2

Mean anginal frequency of the study groups. #Statistically significant difference in both groups from baseline to 2 months (P < 0.001). ++ Significant reduction in ranolazine group at the end of 6 months (P < 0.001)

Figure 3

Exercise tolerance by treadmill test. *Statistically significant difference at baseline. #Statistical significant difference in exercise tolerance between 2 groups at the end of 2 months (P = 0.002). xExercise tolerance was not significant statistically at the end of 6 months (P = 0.062)