Effects of Exercise Training with and without Ranolazine on Peak Oxygen Consumption, Daily Physical Activity and Quality of Life in Patients with Chronic Stable Angina Pectoris

ABSTRACT Ranolazine reduces angina frequency and increases exercise capacity.  We hypothesized that exercise training with ranolazine would allow subjects to train at greater intensities, resulting in greater improvements in exercise capacity, physical activity and health related quality of life (HRQOL).  In a pilot study, subjects with chronic stable angina pectoris were randomized to ranolazine (n=13) or placebo (n=16). Following a two-wk drug titration period, subjects participated in a twelve-wk exercise program.  Peak VO 2 , physical activity (via accelerometer) and HRQOL were assessed before and after training. After exercise training, peak VO 2  increased twice as much with ranolazine (2.1±3.4 mL/kg/min) as with placebo (0.9±1.5) (both P 2 /peak HR) increased in both groups after training; but, the increase was four times greater with ranolazine — resulting in a significant difference between groups (P=0.044). In conclusion, patients with angina, the addition of ranolazine to an exercise program may improve aerobic fitness, physical activity and HRQOL beyond the results of an exercise training program alone. Exercise training with ranolazine led to significantly greater increases in oxygen pulse, which is significantly correlated with stroke volume and is an independent predictor of mortality.