Abstract:
OBJECTIVES:The primary objective of the Monotherapy Assessment of Ranolazine In Stable Angina (MARISA) trial was to determine the dose-response relationship of ranolazine, a potentially new anti-anginal compound, on symptom-limited exercise duration. BACKGROUND:Fatty acids rise precipitously in response to stress, including acute myocardial ischemia. Ranolazine is believed to partially inhibit fatty acid oxidation, shift metabolism toward carbohydrate oxidation, and increase the efficiency of oxygen use. METHODS:Patients (n = 191) with angina-limited exercise discontinued anti-anginal medications and were randomized into a double-blind four-period crossover study of sustained-release ranolazine 500, 1,000, or 1,500 mg, or placebo, each administered twice daily for one week. Exercise testing was performed at the end of each treatment during both trough and peak ranolazine plasma concentrations. RESULTS:Exercise duration at trough increased with ranolazine 500, 1,000, and 1,500 mg twice daily by 94, 103, and 116 s, respectively, all greater (p < 0.005) than the 70-s increase on placebo. Dose-related increases in exercise duration at peak and in times to 1 mm ST-segment depression at trough and peak and to angina at trough and peak were also demonstrated (all p < 0.005). Ranolazine had negligible effects on heart rate and blood pressure. One year survival rate combining data from the MARISA trial and its open-label follow-on study was 96.3 +/- 1.7%. CONCLUSIONS:In chronic angina patients, ranolazine monotherapy was well tolerated and increased exercise performance throughout its dosing interval at all doses studied without clinically meaningful hemodynamic effects. One-year survival was not lower than expected in this high-risk patient population. This metabolic approach to treating myocardial ischemia may offer a new therapeutic option for chronic angina patients.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Chaitman BR,Skettino SL,Parker JO,Hanley P,Meluzin J,Kuch J,Pepine CJ,Wang W,Nelson JJ,Hebert DA,Wolff AA,MARISA Investigators.doi
10.1016/j.jacc.2003.11.045subject
Has Abstractpub_date
2004-04-21 00:00:00pages
1375-82issue
8eissn
0735-1097issn
1558-3597pii
S0735109704001925journal_volume
43pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:OBJECTIVES:This study examined the effects of long-term monotherapy with rosuvastatin (RSV) on the progression of left ventricular (LV) dysfunction and remodeling in dogs with heart failure (HF). BACKGROUND:3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors or "statins" possess other noncholesterol-lowering pr...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2007.04.050
更新日期:2007-08-07 00:00:00
abstract:OBJECTIVES:We hypothesized that the time course of the recovery of atrial systolic function may be related to the duration of atrial fibrillation before cardioversion and sought to study noninvasively the recovery of left atrial mechanical function utilizing serial transthoracic Doppler studies. BACKGROUND:Recovery of...
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doi:10.1016/0735-1097(94)90652-1
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更新日期:2010-11-30 00:00:00
abstract:OBJECTIVES:We sought to study the role of I(KACh) in atrial fibrillation (AF) and the potential electrophysiologic effects of a specific I(KACh) antagonist. BACKGROUND:I(KACh) mediates much of the cardiac responses to vagal stimulation. Vagal stimulation predisposes to AF, but the specific role of I(KACh) in the gener...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01304-3
更新日期:2001-06-15 00:00:00
abstract::Coronary artery reocclusion after thrombolysis with human recombinant tissue-type plasminogen activator (rt-PA) is related to the short half-life of this agent in plasma. K2P, a mutant of rt-PA lacking the fibronectin fingerlike, epidermal growth factor-like and first kringle domains (amino acids 6 to 173) and having ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90164-i
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journal_title:Journal of the American College of Cardiology
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abstract:OBJECTIVES:In view of previous experimental evidence relating sympathetic nervous overactivity in the heart to myocardial necrosis and ventricular arrhythmias, we prospectively examined the hypothesis that heightened cardiac sympathetic nervous activity is associated with an adverse outcome in patients with moderate to...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00332-0
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究
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更新日期:2004-06-02 00:00:00
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更新日期:2017-02-21 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01625-4
更新日期:2001-12-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:2009-06-02 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.10.053
更新日期:2005-02-15 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2019-04-23 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
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更新日期:2014-04-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00579-3
更新日期:2000-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-04-02 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:2007-03-06 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,评审
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更新日期:2020-05-26 00:00:00
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.05.054
更新日期:2004-08-18 00:00:00
abstract:OBJECTIVES:We took advantage of the genetic isolate of Finns to characterize a common long QT syndrome (LQTS) mutation, and to estimate the prevalence of LQTS. BACKGROUND:The LQTS is caused by mutations in different ion channel genes, which vary in their molecular nature from family to family. METHODS:The potassium c...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:2001-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
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更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to examine the interaction between cigarette smoking and the clinical efficacy of clopidogrel in ST-segment elevation myocardial infarction (STEMI). BACKGROUND:Cigarette smoking induces cytochrome P450 (CYP)1A2, which converts clopidogrel into its active metabolite, and prior studi...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
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更新日期:2009-04-14 00:00:00
abstract:BACKGROUND:Data conflict regarding the relative effectiveness of carotid artery stenting (CAS) and carotid artery endarterectomy (CEA) for the prevention of stroke due to carotid artery stenosis. OBJECTIVES:The authors performed an updated meta-analysis evaluating the efficacy and safety of CAS versus CEA, given recen...
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更新日期:2017-05-09 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2007.07.081
更新日期:2007-12-11 00:00:00