The Efficacy And Safety Of Ranolazine In Treatment Of Patients With Coronary Artery Disease:a Systematic Review And Meta-analysis

Backgrounds:Ranolazine is a novel drug which could reduce the deleterious effects of intracellular sodium and calcium overload that accompany myocardial ischemia.However,available studies did not reach a consensus on the efficacy and safety of Ranolazine in treatment of patients suffered from coronary artery disease(CAD).Aims:This systematic review and meta-analysis was designed to evaluate the role of ranolazine in the treatment of CAD.Methods:We searched PubMed,Embase,Cochrane library and CNKI(China National Knowledge Infrastructure database)through July 2016 to identify the studies which investigated the efficacy and safety of Ranolazine therapy in CAD patients.The results were presented as mean differences,risk ratios,hazard ratios,risk differences and number needed to harm with 95%confidence interval.Results:Our qualitative synthesis contained 17 randomized controlled trials(RCTs),and 14 RCTs enrolling 12429 patients were included in the meta-analysis.In efficacy part,compared with control,the Ranolazine treatment improved the angina pectoris(AP)status(weekly angina frequency,nitroglycerin consumption and AP duration),exercise treadmill test performance(exercise duration,time to onset of AP and time to 1 mm ST-segment depression)and Seattle angina questionnaire scores(angina frequency,treatment satisfaction and quality of life dimensions).In safety part.Ranolazine did not increase the risk of recurrent cardiovascular events including all-cause mortality.On the contrary,the medicine reduced the risk of short-term myocardial infarction.Ranolazine was associated with anti-arrhythmic activity instead of arrhythmogenic effect.Constipation,nausea,dizziness,asthenia and syncope were the common adverse effects of Ranolazine treatment,but headache was not.The medicine had no or minor effect on hemodynamic parameters.Conclusions:Ranolazine had good anti-ischemic effects and was well tolerated,and it did not influence or even improve the clinical outcomes of CAD patients.