A pilot study of ranolazine in patients with intermittent claudication

Aim. This pilot study provides preliminary information regarding safety and changes in exercise performance during treatment with ranolazine extended-release in patients with reproducible claudication during exercise treadmill testing (ETT). Methods. We enrolled 45 patients with documented peripheral arterial disease, reproducible claudication on ETY, and ankle-brachial indices <0.85 at rest that decreased by at least 0.15% or 20% immediately postexercise. Randomized patients received double-blind treatment with either ranolazine 1000 mg b.i.d. (n=22) or placebo (n=23) for 4 weeks. Results. Compared with baseline, peak walking time (PWT) increased (mean±SEM) by 53±34 s with ranolazine (P=0.13) and by 41±33 s with placebo (P=0.22). Pain-free walking time during ETT increased by 62±18 s with ranolazine (P=0.002) and 36±18 s with placebo (P=0.045). Supplemental analyses, excluding patients with baseline exercise duration (16 min and (12 min, showed additional improvement with ranolazine on PWT. Conclusions. Ranolazine was well tolerated and these data provide a rationale for proceeding with a definitive trial.