CardioSource WorldNews | Page 17

Admission Therapies After MI and
Life Expectancy in Elderly
What is the association of five acute
myocardial infarction (AMI) therapies with life expectancy and years
of life saved? This is the question

that a retrospective analysis of data
from the Cooperative Cardiovascular
Project attempts to address.
The analysis, published in JACC,

evaluated the association between
life expectancy after AMI and three
guideline-based admission therapies
(aspirin within 48 hours of admission, beta-blockers within 48 hours
of admission, and acute reperfusion therapy within 12 hours of
admission) and two reperfusion

Chronic Angina may
be holding him back
For patients limiting their activity due to
chronic angina, adding Ranexa® may help
In the CARISA Trial1
Ranexa 1000 mg BID,* when added to a beta-blocker
or calcium channel blocker,† was superior to those
treatments plus placebo at:
Increasing exercise duration (24 secs change vs placebo from
baseline at Week 12)
Increasing the time to onset of ischemia during exercise
testing at peak plasma concentrations (94 vs 59 secs)
Decreasing angina frequency (2.1 vs 3.3 avg/wk)
Decreasing nitroglycerin use (1.8 vs 3.1 avg doses/wk)

Learn how Ranexa may help your patients get back on track

www.RanexaHCP.com/CSWN
BID = twice daily
*Limit the dose of Ranexa to 500 mg BID when coadministered with diltiazem, verapamil, or other moderate
CYP3A inhibitors.
†
CARISA TRIAL DESIGN1: CARISA (Combination Assessment of Ranolazine In Stable Angina) was a doubleblind, randomized, placebo-controlled clinical trial of 823 patients with chronic angina who received Ranexa
750 mg BID (n = 272), Ranexa 1000 mg BID (n = 261), or placebo (n = 258) for 12 weeks (note, 750 mg is not
an approved dose). At the physician’s discretion, patients received either atenolol 50 mg, amlodipine 5 mg,
or diltiazem 180 mg once daily as required background antianginal therapy. Sublingual nitrates were used as
needed. Corresponding P-values < 0.05.

Please see following page for brief summary of
Full Prescribing Information.

Dosage and Administration
Begin treatment with 500 mg
twice daily and increase to the
maximum recommended dose
of 1000 mg twice daily, based on
clinical symptoms. Ranexa should
be swallowed whole; do not crush,
break or chew.
Limit the dose of Ranexa to 500 mg
twice daily in patients on moderate
CYP3A inhibitors (e.g., diltiazem,
verapamil, erythromycin,
fluconazole, and grapefruit juice
or grapefruit-containing products).
See Drug Interactions for
additional dosing considerations.
Drug Interactions
Inducers and strong inhibitors
of CYP3A: Do not use Ranexa

(see Contraindications).
Moderate CYP3A inhibitors:
Limit Ranexa to 500 mg twice daily
(see Dosage and Administration).
P-gp inhibitors (e.g.,
cyclosporine): Ranexa exposure
increased; titrate Ranexa based
on clinical response.
CYP3A substrates: Limit
simvastatin to 20 mg once daily
when used with Ranexa. Doses of
other sensitive CYP3A substrates
(e.g., lovastatin) and CYP3A
substrates with narrow therapeutic
range (e.g., cyclosporine,
tacrolimus, sirolimus) may need to
be reduced with Ranexa.
Drugs transported by P-gp
(e.g., digoxin) or metabolized
by CYP2D6 (e.g., tricyclic

antidepressants and
antipsychotics): Doses of these
drugs may need to be reduced.
Drugs transported by OCT2:
Limit metformin to 1700 mg per
day when used with Ranexa
1000 mg twice daily. Monitor
blood glucose and risks associated
with high metformin exposure.

Reference: 1. Chaitman BR, Pepine CJ,
Parker JO, et al. Effects of ranolazine with
atenolol, amlodipine, or diltiazem on exercise
tolerance and angina frequency in patients with
severe chronic angina: a randomized controlled
trial. JAMA. 2004;291:309-316.

Ranexa, the Ranexa logo, Gilead, and the Gilead logo
are registered trademarks of Gilead Sciences, Inc.
©2016 Gilead Sciences, Inc. All rights reserved. RANP0361 02/16

guidelines (D2B within 90 minutes
and door-to-needle [D2N] within 30
minutes of hospital arrival).
Results showed that aspirin on
admission was associated with
0.65 (standard error [SE] 0.05)
years of life saved on average, betablockers with 0.45 (SE 0.06) years