Donate Help Contact The AHA Sign In Home
American Heart Association
Circulation: Cardiovascular Quality and Outcomes
Search: search_blue_button Advanced Search
Circulation: Cardiovascular Quality and Outcomes. 2008;1:107-115
Published online before print November 5, 2008, doi: 10.1161/CIRCOUTCOMES.108.798009
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
1/2/107    most recent
CIRCOUTCOMES.108.798009v2
CIRCOUTCOMES.108.798009v1
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Arnold, S. V.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Arnold, S. V.
Related Collections
Right arrow Health policy and outcome research
Right arrow Cardiovascular Pharmacology
Right arrow Acute coronary syndromes
Right arrow Chronic ischemic heart disease
Right arrowRelated Article

Original Articles

Effects of Ranolazine on Disease-Specific Health Status and Quality of Life Among Patients With Acute Coronary Syndromes

Results from the MERLIN-TIMI 36 Randomized Trial

Suzanne V. Arnold, MD, MHA; David A. Morrow, MD, MPH; Kaijun Wang, PhD; Yang Lei, MS; Elizabeth M. Mahoney, ScD; Benjamin M. Scirica, MD, MPH; Eugene Braunwald, MD; David J. Cohen, MD, MSc on behalf of the MERLIN-TIMI 36 Investigators

From the Saint Luke’s Mid America Heart Institute (S.V.A., K.W., Y.L., E.M., D.J.C.), Kansas City, Mo; and TIMI Study Group (D.A.M., B.M.S., E.B.), Brigham and Women’s Hospital, Boston, Mass.

Correspondence to David J. Cohen, MD, MSc, Cardiovascular Division, Saint Luke’s Mid America Heart Institute, 4401 Wornall Rd, Kansas City, MO 64111. E-mail dcohen{at}saint-lukes.org

Received April 7, 2008; accepted September 5, 2008.

Background— Ranolazine has been shown to reduce myocardial ischemia and symptom severity among selected patients with chronic angina. However, data regarding the effect of ranolazine on health status/quality of life (QOL) are limited.

Methods and Results— We performed a prospective QOL analysis alongside the Metabolic Efficiency with Ranolazine for Less Ischemia in Non–ST-elevation acute coronary syndromes (MERLIN)-TIMI 36 trial, a randomized, double-blind, placebo-controlled trial of ranolazine in 6560 patients with non–ST-elevation acute coronary syndromes. Health status/QOL was evaluated at baseline and 4, 8, and 12 months after index hospitalization using the Seattle Angina Questionnaire, Rose dyspnea scale, SF-12, and EuroQol-5D. Health status/QOL scores improved significantly at all follow-up time points for both treatment arms. In the overall population, randomization to ranolazine was associated with minimal 12-month improvements in angina frequency and Seattle Angina Questionnaire-QOL (P<0.05). In subsequent exploratory analyses, there was a significant interaction between the benefits of ranolazine and anginal status before the index event. Among patients with prior angina (n=3565), treatment with ranolazine was associated with modest benefits across the full range of QOL domains, with the greatest benefits observed in angina frequency (mean effect=3.4; P<0.001) and Seattle Angina Questionnaire-QOL (mean effect=2.7; P<0.001). There were no significant benefits among patients without prior angina, however.

Conclusion— Among a broad population of patients with unstable coronary disease, ranolazine had a minimal effect on disease-specific health status and QOL over {approx}12 months of follow-up. Posthoc subgroup analysis, however, suggested a modest benefit among the subgroup of patients with angina before their acute coronary syndromes event.

Key Words: angina • quality of life • trials • ranolazine


 

CLINICAL PERSPECTIVE

John S. Rumsfeld, MD, PhD, handled this manuscript.

Clinical Trial Registration Information: ClinicalTrials.gov, http://www.clinicaltrials.gov/; trial registration, NCT00099788.


Related Article

Effects of Ranolazine on Disease-Specific Health Status and Quality of Life Among Patients With Acute Coronary Syndromes: Results from the MERLIN-TIMI 36 Randomized Trial
Suzanne V. Arnold, David A. Morrow, Kaijun Wang, Yang Lei, Elizabeth M. Mahoney, Benjamin M. Scirica, Eugene Braunwald, David J. Cohen on behalf of the MERLIN-TIMI 36 Investigators
Circ Cardiovasc Qual Outcomes 2008 1: 107-115. [Abstract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
Circ Cardiovasc Qual OutcomesHome page
H. M. Krumholz
Outcomes Research: Myths and Realities
Circ Cardiovasc Qual Outcomes, January 1, 2009; 2(1): 1 - 3.
[Full Text] [PDF]