Ranolazine is a good drug for control of angina in stable angina patients.In our institutions our experience is better with ranolazine compared to trimetazidine for control of angina. Whether there is any evidence to support that ranolazine has got some mortality benefit in stable angina patients?
There is evidence that ranolazine does not have any effect on CV mortality (HR1.00 CI 0.79-1.25),
Morrow DA, Scirica BM, Karwatowska-prokopczuk E, et al. Effects of ranolazine on recurrent cardiovascular events in patients with non-ST-elevation acute coronary syndromes: the MERLIN-TIMI 36 randomized trial. JAMA. 2007;297(16):1775-83.
Though trials are showing no direct mortality benefit with ranolazine.. There are some indirect evidence that needs to be evaluated by well designed trial. Ranolazine Specially in diabetes have showed reduction of HbA1C,reduction of insulin resistance ,improvement in diastolic function. It has got some protective effect against VT, VF and AF.. Thanks
http://www.acc.org/latest-in-cardiology/articles/2017/06/01/16/10/effect-of-ranolazine-in-type-2-diabetes
https://www.medpagetoday.com/meetingcoverage/hrs/65276
When you have direct evidence considering lack of effect, indirect evidences are not so important. In a conclusion, opinion needs to be based on the best available evidence, which is in this case a RCT which showed lack of effect considering mortality.
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