Ranolazine Does Not Reduce First-incident Ventricular Tachycardia or Ventricular Fibrillation

Ranolazine did not reduce the first incident of ventricular tachyarrhythmia (VT) or ventricular fibrillation (VF), or mortality, in patients with implantable cardioverter defibrillators, results from a new study published in the Journal of the American College of Cardiology suggested. The researchers randomized 510 high-risk patients with ICDs to receive either 1,000 mg ranolazine twice daily (n=510) or placebo (n=502), and designated VT or VF requiring ICD therapy or death (whichever occurred first) as the primary study endpoint.  

Ranolazine: Does it work against recurrent VT/VF in ICD patients? https://t.co/NU8c5Fmo4m #JACC @UofR @DCRINews @DukeHealth pic.twitter.com/twasPaMvwa

— JACC Journals (@JACCJournals) July 31, 2018

According to the results, 372 patients experienced the primary study endpoint (270 with VT/VF, and 148 deaths). Ranolazine did not show a significant improvement in the primary endpoint of VT, VF, or death compared to placebo (HR=0.84; 95% CI, 0.67 to 1.05; P=0.117). In a secondary analysis, patients in the ranolazine group did show a marginally significant reduction in risk for ICD therapies for recurrent VT or VF (HR=0.70; 95% CI, 0.51 to 0.96; P=0.028). 

This study was underpowered to detect a difference in the primary endpoint,” the researchers added in their study. “In prespecified secondary endpoint analyses, ranolazine administration was associated with a significant reduction in recurrent VT or VF requiring ICD therapy without evidence for increased mortality.” 

A pleasure to have participated in the RAID trial with such distinguished colleagues. Read it in @JACCJournals https://t.co/Eu7QWRS7lB @SIAC_cardio @QueensuDOM @QueensuMedia @QueensUHealth @DrStephenArcher @ALFIEEP1 @glover_benedict @Dr_ChrisSimpson @SergioPinski pic.twitter.com/0cTK2Y1X13

— Adrian Baranchuk MD FACC FRCPC FCCS FSIAC (@adribaran) July 31, 2018

Signal that ranolazine may influence risk for ventricular arrhythmia? Results from a randomised trial.https://t.co/N290G9HZbc pic.twitter.com/QZ87MqruNG

— Oliver Segal (@DrOliverSegal) July 31, 2018

RAID trial published in @JACCJournals – In ⬆️risk pts w ICD, ranolazine ❌ ⬇️ the 1ry endpoint of VT, VF, or death. In 2ry analys., it ⬇️recurrent VT or VF req ICD Rx, mainly thru ⬇️in VT w/o proarrhythmia (PMVT)- slow enroll. & ⬆️Rx discont. ➡️underpowered study. https://t.co/B8iURBEfGa

— Amr F Barakat, MD (@AmrFBarakat) July 31, 2018

Source: Journal of the American College of Cardiology