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CARISA was a study in 823 chronic angina patients randomized to receive 12 weeks of treatment with twice-daily Ranexa 750 mg, 1000 mg, or placebo who also continued on daily doses of atenolol 50 mg, amlodipine 5 mg, or diltiazem CD 180 mg.

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An increase in cardiac power induced by β-adrenergic receptor stimulation results in a fall in myocardial malonyl-CoA content and accelerated fatty acid uptake and oxidation; however, this effect is not due to activation of AMPK or reduced ACC activity (, ) but has been associated with a reduction in the K m of MCD(), although this has not been a consistent finding ().

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Dronedarone can decrease the L-type calcium current as well as the sodium current, and these actions may result in a slowing of AV conduction.

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However, results from large randomized trials have not supported this; on the contrary, HRT increases the risk of CVD in women above the age of 60.

Patients with more symptomatic heart disease, including moderate angina, may be guided by an exercise stress test as a means of assessing risk and reassuring the patient.

Ranolazine in combination with beta blockers can be useful when used for relief of anginal symptoms when initial treatment with beta blockers is not successful in patients with SIHD (Class IIb A).

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During treatment, the dose of study drug was permanently decreased during the intravenous phase due to an adverse event in 63 patients (1.

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In an acute cardiovascular disease event where the patient is suffering from or at risk of suffering from renal insufficiency, the use of such concentrations of ranolazine can result in higher ranolazine plasma levels.

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It is important to remember that data demonstrating improved prognosis following appropriate management are still lacking.

Myocardial contrast echocardiography, which utilizes microbubbles, allows assessment of myocardial perfusion, which provides information beyond wall thickening assessment during both vasodilator and inotropic stress echocardiography.

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This review discusses 1) the metabolic changes that occur in chronic HF, with emphasis on the mechanisms that regulate the changes in the expression of metabolic genes and the function of metabolic pathways; 2) the consequences of these changes on cardiac function; 3) the role of changes in myocardial substrate metabolism in ventricular remodeling and disease progression; and 4) the therapeutic potential of acute and long-term manipulation of cardiac energy metabolism in HF.

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The most common adverse events that led to discontinuation more frequently on Ranexa than placebo were dizziness (1.

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Identifying high-risk persons before their first myocardial event is a multifaceted process that involves both patient and physician education efforts.

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Some contraindications for ranolazine are related to its metabolism and are described under Drug Interactions.

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Recent studies suggest other effects of ranolazine that may explain its anti-anginal and anti-arrhythmic effects.

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In the Heart Outcomes Prevention Evaluation (HOPE) study, high-risk patients for the presence of CAD without a history of a MI who were treated with the ACE inhibitor ramipril experienced a significant reduction in major cardiac events.

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The time to onset of angina at trough and peak plasma concentrations was also greater with ranolazine.

Ranolazine, through inhibition of the late sodium current, has been well tolerated and effective in patients with CSAP.

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