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Ranolazine as Add-on Therapy for Patients With Severe Chronic Angina—Reply
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In Reply: In response to Drs Hooper and Busti, the improvements in exercise performance due to ranolazine in our study, as well as the magnitude of the placebo effect, are similar to those reported in studies of other widely prescribed antianginal drugs.1 In an earlier cross-over study of immediate-release ranolazine 400 mg twice daily vs atenolol 100 mg/d vs placebo, ranolazine at plasma concentrations similar to those in our study produced increases in exercise performance that were as large or larger than those effected by atenolol.2
We disagree that the antianginal and anti-ischemic benefits in trial are confounded by statin usage. The use of statin therapy was equally distributed across the 3 treatment arms at baseline, and the rate of statin discontinuation or initiation was low during the double-blind treatment phase (<1.2% per group) and occurred with a similar frequency across the 3 treatment groups.
We agree with Hooper and . . . [Full Text of this Article]
Bernard R. Chaitman, MD
chaitman@slu.edu
Department of Medicine
St Louis University School of Medicine
St Louis, Mo
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