Ranolazine ineffective as antianginal following incomplete revascularization

Ranolazine is a novel anti-anginal medication that operates via late sodium channel blockade, reducing intracellular calcium during ischemia. Prior studies suggest ranolazine is effective in reducing the symptoms of angina among patients with ischemic heart disease. Although revascularization is often used to address symptoms, incomplete revascularization with residual ischemic symptoms is common. In the current study, the investigators evaluated ranolazine versus placebo in post-PCI patients with incomplete revascularization on the rates of ischemia-driven revascularization or hospitalization. The investigators enrolled 2651 patients into this trial, randomizing to ranolazine or placebo within 14 days of the index percutaneous intervention. Patients were included if they had a history of angina and underwent PCI, but were incompletely revascularized (>50% stenosis in at least one lesion in an epicardial vessel greater than 2.0 mm in diameter). The investigators measured time to ischemia-driven revascularization or hospitalization from randomization, as well as endpoints of time to sudden cardiac death, cardiovascular death or myocardial infarction. After a median follow-up of 643 days, there was no significant difference between placebo and ranolazine for the primary endpoint (hazard ratio 0.95, 95% confidence interval 0.82–1.10), or for …