A pilot randomized study of ranolazine for reduction of myocardial damage during elective percutaneous coronary intervention
American Heart Journal, 05/24/2012
Pelliccia F et al. – Pretreatment with ranolazine 1,000 mg twice daily for 7 days significantly reduced procedural myocardial injury in elective percutaneous coronary intervention (PCI).Methods
- Seventy patients with stable angina (age 62 ± 18 years, 42 men) scheduled for elective coronary intervention entered a randomized, double–blind, placebo–controlled pilot trial.
- For 7 days before the procedure, 35 patients were assigned to receive ranolazine (1,000 mg twice daily) and 35 patients had placebo.
- Creatine kinase–MB and troponin I levels were measured at baseline and at 8 and 24 hours postprocedure.
- Comparison between the 2 groups did not show any difference in clinical features, extent of coronary artery disease, and technical aspects of PCI.
- Periprocedural myocardial infarction (ie, postprocedural increase of creatine kinase–MB ≥3 times above the upper limit of normal) was less commonly seen after PCI in the ranolazine than in the placebo group (6% vs 22%, P = .041).
- Detection of markers of myocardial injury above the upper limit of normal tended to be lower in the ranolazine vs placebo group: 23% vs 40% for creatine kinase–MB (P = .192) and 31% vs 48% for troponin I (P = .223).
- Postprocedural peak markers levels were also significantly lower in the ranolazine vs placebo group (creatine kinase–MB: 3.1 ± 15.0 and 7.7 ± 19.1 ng/mL, P < .05; troponin I: 0.15 ± 0.35 and 0.47 ± 0.49 ng/mL, P < .05).
- No significant adverse effect was reported by the 2 groups of patients.