Key result
A 6-week ranolazine add-on therapy showed a trend toward a higher normal fraction of cumulative global strain compared to standard treatment (15% vs 11%) in patients with acute cardiac ischemia.
Why the study?
Does ranolazine added to standard treatment reduce the area of ischemic myocardium in patients with acute cardiac ischemia?
RCT (n=20)
randomized
Does ranolazine added to standard treatment reduce the area of ischemic myocardium in patients with acute cardiac ischemia?
A 6-week ranolazine add-on therapy in patients with acute cardiac ischemia showed a trend toward decreasing the area of dyskinetic myocardium as measured by speckle-tracking echocardiography.
Answers are grounded in this paper and cite their sources.
Pilot supports ranolazine feasibility in AMI; leaves open efficacy for reducing ischemic myocardium.
BACKGROUND: current blocker ranolazine has shown to reduce the risk of recurrent ischemia and worsening of angina in patients with non-ST-segment elevation ACS by possibly improving myocardial perfusion, but up to now no trial has addressed whether this enhanced perfusion also leads to a decrease in ischemic myocardium of patients with ACS. We designed a pilot trial (Reduction of Ischemic Myocardium with Ranolazine-Treatment IN patients with acute myocardial Infarction, ClinicalTrials.gov Identifier: NCT01797484) for feasibility and proof of concept that a 6-week ranolazine add-on therapy would reduce the area of ischemic myocardium in patients with ACS. METHODS AND RESULTS: The trial was designed in a 2-armed, controlled and randomized way. Twenty participants with unstable angina, proof of acute cardiac ischemia, and myocardial dyskinesia by speckle-tracking echocardiography were included. Ten participants received the study drug ranolazine additionally to standard treatment. The control group received standard treatment without additional study medication. Speckle-tracking echocardiography was performed before coronary intervention, before the first dose of ranolazine, and after 6 weeks of ranolazine treatment. Ranolazine was administered safely during acute myocardial infarction. Speckle-tracking echocardiography proved to be suitable for evaluation of myocardial dyskinesia. Patients receiving ranolazine showed a trend to higher normal fraction of the cumulative global strain than patients in the standard treatment group (15% vs 11%). No major complications relating study medication were observed. CONCLUSION: In conclusion, in this preliminary hypothesis-driven study, 6-week ranolazine therapy was shown to decrease the area of dyskinetic myocardium in patients with ACS by trend. Global strain rate measurement using speckle-tracking echocardiography can be applied measuring those effects and is, compared to other techniques, safe and harmless. Our data provide a sound basis for a follow-up trial.
No takes yet. Share an insight, caveat, or question.
Schwemer et al. (2018) conducted an RCT in Acute cardiac ischemia (n=20). Ranolazine vs. Standard treatment was evaluated on Normal fraction of the cumulative global strain. A 6-week ranolazine add-on therapy showed a trend toward a higher normal fraction of cumulative global strain compared to standard treatment (15% vs 11%) in patients with acute cardiac ischemia.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: