ABSTRACT
Background: Although ranolazine has been available for years as a second-line treatment to reduce angina attacks in patients with stable angina pectoris, real-world data on the effectiveness, tolerability, and safety of ranolazine are limited. Methods: A non-interventional, prospective study was conducted to assess the effectiveness and safety of ranolazine. Patients eligible for enrolment had a baseline assessment between one and fourteen days after initiating ranolazine for the first time and a follow-up visit three months later. The primary endpoints comprised the weekly frequency of angina attacks, total adverse events, and ranolazine discontinuation rate. The secondary endpoints included the use of short-acting nitrates, changes on the Canadian Cardiovascular Society (CCS) angina classification score and quality of life scale score (QoL). Results: In total, 1101 patients were enrolled at 214 sites. Mean weekly angina attacks were reduced from 3.6 ± 2.9 to 0.4 ± 0.9 (p < 0.0001) and the mean weekly consumption of short-acting nitrates decreased by 1.7 ± 2.2 (p < 0.0001). CCS class and QoL were also improved (p < 0.0001). Adverse events were reported by 11 (1%) patients in total, while 2 of them (0.2%) were characterised as serious. Treatment was discontinued for various reasons in 23 patients (2.1%) after the follow-up period. Ranolazine treatment was equally effective in all subgroups tested, with larger benefits observed in patients with more frequent angina and CCS angina class III and IV. Up-titration of ranolazine during the study improved the outcomes. Conclusions: Ranolazine was well tolerated and effectively reduced angina attacks, with simultaneous improvement of the CCS class and QoL score in patients with stable angina.
ABSTRACT
Since the introduction of the use of the radial artery as the means of access for coronary angiography by Campeau in 1989 and for angioplasty by Kiemeneij and Laarman in 1993, this artery is increasingly becoming the preferred route of access for percutaneous coronary intervention. The two main driving forces behind this have been the colossal advances in technology that led to miniaturization of catheters and the excellent results achieved with regard to vascular complications, despite the aggressive use of multiple potent antiplatelet and anticoagulant agents during percutaneous coronary interventions. More and more interventional centers are in the process of setting up a transradial program to adopt the transradial approach. This article concentrates on the practical aspects of setting up a transradial program and offers practical advice on how to go about it.
