Harlan M. Krumholz, MD, SM reviewing Fanaroff AC et al. J Am Coll Cardiol 2017 May 9.

The anti-anginal drug does not improve angina frequency in this population.

Ranolazine remains a modestly popular anti-anginal drug. These researchers performed a prespecified substudy of its effect in diabetes patients enrolled in the multicenter, placebo-controlled RIVER-PCI trial of 2651 patients with chronic angina and incomplete revascularization after percutaneous coronary intervention (NEJM JW Cardiol Feb 2016 and Lancet 2016; 387:136). In RIVER-PCI, no difference was seen in the primary endpoint (first occurrence of ischemia-driven revascularization or ischemia-driven hospitalization without revascularization) at a median follow-up of 643 days.

In this substudy examining 961 patients with diabetes, angina frequency at 12 months did not differ between ranolazine and placebo (least squares mean difference: 1.77; Seattle Angina Questionnaire scores, 88.2 and 86.6). Ranolazine compared with placebo showed a least squares mean reduction in glycosylated hemoglobin of 0.44% at 12 months, an association known from previous studies.

CITATION(S):

Fanaroff AC et al. Ranolazine after incomplete percutaneous coronary revascularization in patients with versus without diabetes mellitus: RIVER-PCI trial. J Am Coll Cardiol 2017 May 9; 69:2304. 

JWatch