Ranolazine effectively improves clinical symptoms in patients with slow flow coronary arteries: a randomized, double-blind, placebo-controlled clinical trial

The coronary slow flow phenomenon (CSF) causes persistent chest pains that can affect patients' quality of life. We aimed to examine the ranolazine impacts on clinical symptoms in CSF patients. The present randomized, double-blind, placebo-controlled trial consisted of 44 patients with CSF. For two months, patients were randomized to receive ranolazine (500 mg/twice daily) or placebo plus optimal medications. EuroQol-visual analogic scale (VAS) and Seattle Angina Questionnaire (SAQ) were performed at baseline and after one and two months of treatment. At the beginning and after one month of treatment, no remarkable difference was assumed in the mean of EuroQol-VAS and all five SAQ parameters between the ranolazine and placebo groups. Additionally, the median of EuroQol-VAS (P < 0.001) and all five SAQ parameters, including physical limitation (P < 0.001), stability of angina (P < 0.001), frequency of angina (P < 0.001), treatment satisfaction (P = 0.003 and P < 0.001), and understanding of the disease (P < 0.001), has significantly propagated after two months of treatment in both ranolazine and placebo groups. Interestingly, following two months of treatment, the mean of EuroQol-VAS (P = 0.013), physical limitation (P = 0.041), stability of angina (P = 0.016), frequency of angina (P = 0.042), and treatment satisfaction (P = 0.037), in the ranolazine group has notably elevated comparatively to the placebo group. Our findings showed that ranolazine ameliorates clinical symptoms in CSF patients after two months of treatment. Therefore, ranolazine may be an appropriate candidate in CSF patients.