Evidence map›Paper›PMID 26614823›Full record

Trial reportEuropean heart journal2016

A randomized, placebo-controlled trial of late Na current inhibition (ranolazine) in coronary microvascular dysfunction (CMD): impact on angina and myocardial perfusion reserve.

C Noel Bairey Merz, Eileen M Handberg, Chrisandra L Shufelt, Puja K Mehta, Margo B Minissian, Janet Wei, Louise E J Thomson, Daniel S Berman, Leslee J Shaw, John W Petersen and 6 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01342029 (Treatment With Ranolazine in Microvascular Coronary Dysfunction), which is not on this map. Cited by 113 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
113citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01342029 nacompletednot on this map

Treatment With Ranolazine in Microvascular Coronary Dysfunction (MCD): Impact on Angina Myocardial Ischemia

TypeinterventionalSponsorCedars-Sinai Medical CenterRan2011 to 2016Enrolled142ConditionsMicrovascular Coronary Dysfunction (MCD)ArmsRanolazine, Placebo
3 · Its place in the literature

Who cites it

113 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. A systematic review of enrolment criteria and treatment efficacy for microvascular angina.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025
    Pooled it
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  5. Guideline
  6. Ranolazine for stable angina pectoris.The Cochrane database of systematic reviews · 2017
    Pooled it
  7. Trial
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  14. Article
  15. Contemporary Antianginal Therapy.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026
    Review
  16. Review
  17. Guideline for Chronic Coronary Syndrome - 2025.Arquivos brasileiros de cardiologia · 2025
    Article
  18. Article
  19. Article
  20. Article

53 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

C Noel Bairey MerzBarbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA noel.baireymerz@cshs.org.
Eileen M HandbergDivision of Cardiology, University of Florida, Gainesville, FL, USA.
Chrisandra L ShufeltBarbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
Puja K MehtaBarbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
Margo B MinissianBarbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
Janet WeiBarbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
Louise E J ThomsonS. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Daniel S BermanS. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Leslee J ShawProgram in Cardiovascular Outcomes Research and Epidemiology, Emory University, Atlanta, GA, USA.
John W PetersenDivision of Cardiology, University of Florida, Gainesville, FL, USA.
Garrett H BrownDivision of Cardiology, University of Florida, Gainesville, FL, USA.
R David AndersonDivision of Cardiology, University of Florida, Gainesville, FL, USA.
Jonathan J ShusterHealth Outcomes and Policy, University of Florida Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA.
Galen Cook-WiensBiostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
André RogatkoBiostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Carl J PepineDivision of Cardiology, University of Florida, Gainesville, FL, USA.

Funding

ZONA-FREE HAMSTER OVA ASSAY AS AN INDICATOR OF MALE FERTILITYM01RR000425 · LOS ANGELES COUNTY HARBOR-UCLA MED CTR · 1985 to 2005
$38.7M
Training in Advanced Heart Disease ResearchT32HL116273 · NHLBI · CEDARS-SINAI MEDICAL CENTER · 2023 to 2025
$867k
NCATS NIH HHS UL1 TR000064NCATS NIH HHS UL1 TR001427NCRR NIH HHS M01 RR000425NCRR NIH HHS UL1 RR033176NHLBI NIH HHS R01 HL089765NHLBI NIH HHS T32 HL116273
6 · The paper itself

Abstract

aimsThe mechanistic basis of the symptoms and signs of myocardial ischaemia in patients without obstructive coronary artery disease (CAD) and evidence of coronary microvascular dysfunction (CMD) is unclear. The aim of this study was to mechanistically test short-term late sodium current inhibition (ranolazine) in such subjects on angina, myocardial perfusion reserve index, and diastolic filling. MATERIALS AND

resultsRandomized, double-blind, placebo-controlled, crossover, mechanistic trial in subjects with evidence of CMD [invasive coronary reactivity testing or non-invasive cardiac magnetic resonance imaging myocardial perfusion reserve index (MPRI)]. Short-term oral ranolazine 500-1000 mg twice daily for 2 weeks vs. placebo. Angina measured by Seattle Angina Questionnaire (SAQ) and SAQ-7 (co-primaries), diary angina (secondary), stress MPRI, diastolic filling, quality of life (QoL). Of 128 (96% women) subjects, no treatment differences in the outcomes were observed. Peak heart rate was lower during pharmacological stress during ranolazine (-3.55 b.p.m., P < 0.001). The change in SAQ-7 directly correlated with the change in MPRI (correlation 0.25, P = 0.005). The change in MPRI predicted the change in SAQ QoL, adjusted for body mass index (BMI), prior myocardial infarction, and site (P = 0.0032). Low coronary flow reserve (CFR <2.5) subjects improved MPRI (P < 0.0137), SAQ angina frequency (P = 0.027), and SAQ-7 (P = 0.041).

conclusionsIn this mechanistic trial among symptomatic subjects, no obstructive CAD, short-term late sodium current inhibition was not generally effective for SAQ angina. Angina and myocardial perfusion reserve changes were related, supporting the notion that strategies to improve ischaemia should be tested in these subjects.

trial registrationclinicaltrials.gov Identifier: NCT01342029.

Indexed as

Administration, OralAngina PectorisCoronary DiseaseCross-Over StudiesDouble-Blind MethodDrug Administration ScheduleFemaleHemodynamicsHumansMagnetic Resonance AngiographyMaleMedication AdherenceMicrovesselsMiddle AgedMyocardial IschemiaQuality of LifeRanolazineSodium Channel BlockersAnginaCoronary microvascular dysfunction

Identifiers

PMID26614823
PMCPMC4872284

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.