Ranolazine in Microvascular Dysfunction

Slides:

Advertisements

Similar presentations

CONSENSUS: Cooperative North Scandinavian Enalapril Survival Study Purpose To determine whether the ACE inhibitor enalapril reduces mortality in patients.

Advertisements

The ERICA Trial Peter H. Stone, MD, FACC, Nikolay A. Gratsiansky, MD, Alexey Blokhin, MD, I-Zu Huang, MD, Lixin Meng, MS, MPH, for the ERICA Investigators.

BEAUTI f UL: morBidity-mortality EvAlUaTion of the I f inhibitor ivabradine in patients with coronary disease and left ventricULar dysfunction Purpose.

Clinical Trial Results. org The Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) Trial François Lespérance,

Myocardial Ischemia Redefined: Optimal Care in CAD.

WOSCOPS: West Of Scotland Coronary Prevention Study Purpose To determine whether pravastatin reduces combined incidence of nonfatal MI and death due to.

Study Design Scirica BM, Bhatt DL Braunwald et al, Sexagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med

Published in Circulation 2003 Rory Hachamovitch, MD, MSc; Sean W. Hayes, MD; John D. Friedman, MD; Ishac Cohen PhD; Daniel S. Berman, MD Comparison of.

LIPID: Long-term Intervention with Pravastatin in Ischemic Disease Purpose To determine whether pravastatin will reduce coronary mortality and morbidity.

Effects of Ranolazine: from Angina to Cardiac Performance Iacopo Olivotto, MD Referral Center for Cardiomyopathies Careggi University Hospital Florence,

Effects of Ranolazine on Angina and Quality of Life Following PCI with Incomplete Revascularization -- The Ranolazine for Incomplete Vessel Revascularization.

Efficacy of Ranolazine In Chronic Angina trial

4S: Scandinavian Simvastatin Survival Study

STICH CABG Objective To determine whether surgery plus medical management or medical management alone improve outcomes in CABG patients Study Design 1212.

Many alternatives for treating ischemia and angina: how to choose?

Rosuvastatin 10 mg n=2514 Placebo n= to 4 weeks Randomization 6weeks3 monthly Closing date 20 May 2007 Eligibility Optimal HF treatment instituted.

Long-Term Tolerability of Ticagrelor for Secondary Prevention: Insights from PEGASUS-TIMI 54 Trial Marc P. Bonaca, MD, MPH on behalf of the PEGASUS-TIMI.

Long-Term Tolerability of Ticagrelor for Secondary Prevention: Insights from PEGASUS-TIMI 54 Trial Marc P. Bonaca, MD, MPH on behalf of the PEGASUS-TIMI.

Effects of Ranolazine on Angina and Quality of Life Following PCI with Incomplete Revascularization -- The Ranolazine for Incomplete Vessel Revascularization.

Search strategy and results Amir Kashani, et al. Circulation. 2006;114:

The NHLBI TIME Trial: Role of Microvascular Obstruction in 2-Year Clinical and MRI Follow-up Jay H. Traverse, MD Principal Investigator, TIME Study Minneapolis.

IRIS Trial design: Patients without diabetes with a history of stroke or TIA within 6 months, with objective evidence of insulin resistance (HOMA-IR value.

Mean Responses on PGI-Improvement Primary Endpoint at Week 12

SOCRATES Trial design: Patients with acute ischemic stroke were randomized in a 1:1 fashion to receive either ticagrelor 180 mg load + 90 mg BID or aspirin.

Comparison of the Short-Term Survival Benefit Associated With Revascularization Compared With Medical Therapy in Patients With No Prior Coronary Artery.

EARLY-BAMI Trial design: Patients presenting with STEMI with a plan for primary PCI, and without evidence of cardiogenic shock, were randomized to either.

SAVE Trial design: Patients with moderate to severe obstructive sleep apnea (OSA) and known CV disease were randomized in a 1:1 fashion to either CPAP.

GAUSS-3 Trial design: Patients with objective evidence of intolerance to statin agents were randomized in a 2:1 fashion to either evolocumab 420 mg subcutaneously.

Figure 2 Different manifestations of myocardial ischaemia

ATLANTIC Trial design: Participants with STEMI being transported for primary PCI were randomized in the ambulance to ticagrelor 180 mg (n = 909) vs. placebo.

AARDVARK Trial design: Patients with small abdominal aortic aneuryms (AAAs) were randomized in a 1:1:1 fashion to either perindopril 10 mg once daily,

LEVO-CTS Trial design: Patients undergoing cardiac surgery with the use of cardiopulmonary bypass were randomized to infusion of levosimendan 0.2 µg/kg/min.

How and When to Decide on Revascularization in Stable Ischemic Heart Disease.

BBK II Trial design: Patients undergoing a two-stent approach for a de novo bifurcation lesion were randomized in a 1:1 fashion to either culotte stenting.

EMPA-REG OUTCOME Trial design: Patients with type 2 diabetes mellitus (DM2) at high risk for CV events were randomized to receive in a 1:1:1 fashion either.

EVITA Trial design: Smokers admitted with an acute coronary syndrome were randomized to varenicline 1 mg twice daily (n = 151) vs. placebo (n = 151). Study.

MAGIC-AF Trial design: Patients with persistent atrial fibrillation (AF) and remaining in AF after pulmonary vein isolation alone were randomized to either.

MARFAN SARTAN Trial design: Marfan patients were randomized to losartan (n = 153) vs. placebo (n = 150). The dose of losartan was 50 mg for those

ALPS Trial design: Patients with adult nontraumatic out-of-hospital cardiac arrest (OOHCA) and persistent or recurrent VT/VF after ≥1 shock were randomized.

% decrease in LDL-C at 24 weeks from baseline

% decrease in LDL-C at 24 weeks from baseline

SIGNIFY Trial design: Participants with stable coronary artery disease without clinical heart failure and resting heart rate >70 bpm were randomized to.

FAMOUS-NSTEMI Trial design: Participants with NSTEMI were randomized to an FFR-guided strategy (n = 176) vs. a coronary angiography-guided strategy (n.

Modified Rankin score 0-2

ATMOSPHERE Trial design: Patients with symptomatic heart failure were randomized in a 1:1:1 fashion to either aliskiren 300 mg once daily, enalapril 5.

SUSTAIN-6 Trial design: Patients with DM2 at high risk for CV events were randomized in a 1:1:1:1 fashion to either semaglutide 0.5 mg, semaglutide 1 mg,

LATITUDE-TIMI 60 Trial design: Patients hospitalized with AMI on guideline-recommended therapy were randomized in a 1:1 fashion to either losmapimod 7.5.

Insomnia pharmacotherapy: Off-label antipsychotics

BAT for HFrEF Trial design: Patients with chronic systolic HF were randomized in a 1:1 fashion to either baroreceptor activation therapy (BAT) or control.

NIPPON Trial design: Patients undergoing percutaneous coronary intervention were randomized to short-term dual antiplatelet therapy (DAPT) (6 months; n.

TACTICS-HF Trial design: Patients with acute heart failure (reduced or preserved ejection fraction) were randomized to tolvaptan 30 mg at 0, 24, and 48.

RIDDLE-NSTEMI Trial design: Patients with NSTEMI were randomized to either immediate (within 2 hours) intervention or delayed (within 72 hours) intervention.

FOURIER Trial design: Patients with established cardiovascular disease on statin therapy were randomized to evolocumab 140 mg subcutaneous every 2 weeks.

Efficacy and safety of niacin/laropiprant

BRAVO-3 Trial design: Patients undergoing transfemoral TAVR were randomized in a 1:1 fashion to bivalirudin or UFH. They were followed for 30 days. Results.

OSLER Trial design: Patients from five phase 2 trials and seven phase 3 trials with evolocumab were invited to participate in the OSLER extension program,

IMPRESSION Trial design: Patients presenting with acute MI and undergoing an invasive approach, along with ticagrelor loading dose, were randomized to.

(p for noninferiority < 0.001)

Association between Nonalcoholic Fatty Liver Disease at CT and Coronary Microvascular Dysfunction at Myocardial Perfusion PET/CT Coronary microvascular.

HARMONIZE Trial design: Patients with hyperkalemia (K ≥5.1 mEq/L) were randomized in a 1:1:1:1.7 fashion to receive sodium zirconium cyclosilicate (ZS)

ACCELERATE Trial design: Patients at high vascular risk were randomized to either evacetrapib 130 mg daily or placebo. They were followed for 30 months.

POPE-2 Trial design: Patients with moderate to large pericardial effusion after cardiac surgery were randomized to colchicine 2 mg loading dose, then 1.

Metoprolol for AR Trial design: Patients with chronic asymptomatic severe aortic regurgitation (AR) were randomized to metoprolol CR/XL 200 mg or matching.

Remote ischemic preconditioning

TRUE-AHF Trial design: Patients with acute decompensated heart failure were randomized in a 1:1 fashion to either early ularitide infusion (within 12 hours)

SOLID-TIMI 52 Trial design: Participants within 30 days of an acute coronary syndrome (ACS) were randomized to darapladib 160 mg daily (n = 6,504) versus.

STOP-CHAGAS Trial design: Asymptomatic patients with serological evidence of T. cruzi were randomized to posaconazole 400 mg BID, benznidazole 200 mg BID,

Spydergram of mean SF-36 domain scores at baseline and weeks 12 (A) and 24 (B) for sarilumab 150 mg and 200 mg+csDMARDs compared with placebo+csDMARDs.

CIRCUS Trial design: Patients with anterior STEMI were randomized to IV cyclosporine 2.5 mg/kg (n = 475) vs. placebo (n = 495) immediately before coronary.

Traditional cardiovascular risk factors can cause cardiac disease in patients with IIM. Systemic and local inflammation may either have a direct effect.

Presentation transcript:

Ranolazine in Microvascular Dysfunction Trial design: Patients with coronary ischemic symptoms and objectively documented CMD without significant epicardial stenoses were randomized in a 2 x 2 cross-over fashion to either ranolazine 500-1000 mg or placebo. They were followed for 2 weeks. Results (p > 0.05) Primary endpoint: Seattle Angina Questionnaire overall scores for ranolazine vs. placebo: 62.5 vs. 61.0, p > 0.05 Anginal frequency: 63.9 vs. 62.7; p = 0.97; anginal episodes: 4.8 vs. 4.9, p = 0.81 Depressed (on HIS-GWB Mental Health Battery scale): 4.4 vs. 4.3, p = 0.0009 Conclusions Short-term ranolazine was not superior to placebo in improving anginal symptoms, myocardial perfusion, or diastolic filling in patients with documented CMD and no significant epicardial stenoses (96% women) Patients with CFR <2.5 had improvements in myocardial perfusion reserve index, suggesting a possible role for this therapy in this patient subset Primary endpoint Ranolazine (n = 128) Placebo (n = 128) Bairey Merz CN, et al. Eur Heart J 2016;37:1504-13