Effect of Ranolazine on Myocardial Perfusion Assessed by Serial Quantitative Exercise SPECT Imaging

NCT ID: NCT01221272

Last Updated: 2014-09-03

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

81 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-09-30

Study Completion Date

2012-09-30

Brief Summary

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This study enrolled participants with documented exercise-induced myocardial ischemia in order to evaluate whether ranolazine, when taken prior to exercise, can improve blood flow to the heart (myocardial perfusion), as assessed by exercise-induced myocardial perfusion defect size (PDS) and total perfusion deficit (TPD), using gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).

This was a 2-period crossover study. The last dose of each period must have been taken 3-4 hours prior to conduct of the exercise SPECT MPI. After the research exercise SPECT MPI was performed at the end of Period 1, participants discontinued the treatment they were randomized to for that period and began the other treatment in Period 2.

Detailed Description

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Conditions

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Myocardial Perfusion Imaging Myocardial Ischemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Ranolazine/Placebo

Participants received ranolazine from Day 1 through Day 15 (± 2 days) of Period 1, followed by an exercise SPECT MPI study, then received placebo to match ranolazine from Day 1 through Day 15 (± 2 days) of Period 2, followed by an exercise SPECT MPI study.

Group Type EXPERIMENTAL

Ranolazine

Intervention Type DRUG

* One 500 mg tablet in the evening on Day 1 of the period
* One 500 mg tablet, twice daily on Days 2-3 of the period
* Two 500 mg tablets (1000 mg total), twice daily from Day 4 to the end of the period (Day 15 ± 2 days)

Placebo to match ranolazine

Intervention Type DRUG

Placebo to match ranolazine administered in the same form and frequency as the active drug.

SPECT MPI

Intervention Type PROCEDURE

Gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) to confirm the presence of reversible exercise-induced left ventricular perfusion defect size (PDS) performed within 12 weeks prior to baseline or at the baseline visit, and at the end-of-period 1 and end-of-period 2 visits.

Exercise

Intervention Type BEHAVIORAL

Treadmill stress test

Placebo/Ranolazine

Participants received placebo to match ranolazine from Day 1 through Day 15 (± 2 days) of Period 1, followed by an exercise SPECT MPI study, then received ranolazine from Day 1 through Day 15 (± 2 days) of Period 2, followed by an exercise SPECT MPI study.

Group Type EXPERIMENTAL

Ranolazine

Intervention Type DRUG

* One 500 mg tablet in the evening on Day 1 of the period
* One 500 mg tablet, twice daily on Days 2-3 of the period
* Two 500 mg tablets (1000 mg total), twice daily from Day 4 to the end of the period (Day 15 ± 2 days)

Placebo to match ranolazine

Intervention Type DRUG

Placebo to match ranolazine administered in the same form and frequency as the active drug.

SPECT MPI

Intervention Type PROCEDURE

Gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) to confirm the presence of reversible exercise-induced left ventricular perfusion defect size (PDS) performed within 12 weeks prior to baseline or at the baseline visit, and at the end-of-period 1 and end-of-period 2 visits.

Exercise

Intervention Type BEHAVIORAL

Treadmill stress test

Interventions

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Ranolazine

* One 500 mg tablet in the evening on Day 1 of the period
* One 500 mg tablet, twice daily on Days 2-3 of the period
* Two 500 mg tablets (1000 mg total), twice daily from Day 4 to the end of the period (Day 15 ± 2 days)

Intervention Type DRUG

Placebo to match ranolazine

Placebo to match ranolazine administered in the same form and frequency as the active drug.

Intervention Type DRUG

SPECT MPI

Gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) to confirm the presence of reversible exercise-induced left ventricular perfusion defect size (PDS) performed within 12 weeks prior to baseline or at the baseline visit, and at the end-of-period 1 and end-of-period 2 visits.

Intervention Type PROCEDURE

Exercise

Treadmill stress test

Intervention Type BEHAVIORAL

Other Intervention Names

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Ranexa®

Eligibility Criteria

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Inclusion Criteria

* Exercise SPECT MPI study (stress and rest) showing at least 10% reversible myocardial ischemia (as confirmed by the core nuclear laboratory using Corridor4DM imaging software) performed not more than 12 weeks prior to screening, OR
* Exercise SPECT MPI study (stress and rest) conducted during screening (after consultation with the Medical Monitor and after informed consent was obtained) showing at least 10% reversible myocardial ischemia (as confirmed by the core nuclear laboratory)
* Stable antianginal medical therapy (excluding short-acting nitroglycerin)

Exclusion Criteria

* Left bundle branch block
* Automated implantable defibrillator and/or pacemaker (selected subjects with permanent pacemakers who had an intact sinus mechanism may have been included following consultation with the Medical Monitor)
* Intervening coronary revascularization between the time of qualifying exercise SPECT MPI study and randomization
* Acute myocardial infarction (MI) within 60 days prior to screening or at any time after the qualifying exercise SPECT MPI study, or MI undergoing staged intervention during a subject's participation in the trial
* Unstable angina within 30 days prior to screening, or at any time after the qualifying exercise SPECT MPI study
* Coronary artery bypass graft surgery within 60 days prior to screening or at any time after the qualifying exercise SPECT MPI study, or percutaneous coronary intervention within 30 days prior to screening or at any time after the qualifying exercise SPECT MPI study
* Anticipated coronary revascularization during the trial period
* Cerebrovascular attack or transient ischemic attack within 90 days prior to screening
* History of serious arrhythmias
* Current atrial fibrillation or atrial flutter
* QTc interval \> 500 milliseconds
* Diagnosed as having New York Heart Association Class III or IV heart failure
* Inability to exercise or exercise limitation due to other comorbidities that may have interfered with ability to perform required exercise SPECT MPI study
* Body mass index greater than or equal to 38 kg/m\^2 (may have been up to 40 kg/m\^2 after consultation with the Medical Monitor)
* Any absolute contraindications to exercise stress testing
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gilead Sciences

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Patrick Yue, MD

Role: STUDY_DIRECTOR

Gilead Sciences

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Imperial Cardiac Center

Imperial, California, United States

Site Status

Clinical Trials Research

Lincoln, California, United States

Site Status

Mission Internal Medical Group

Mission Viejo, California, United States

Site Status

Central Coast Cardiology

Salinas, California, United States

Site Status

Alfieri Cardiology

Newark, Delaware, United States

Site Status

St. Luke's Cardiology Associates

Jacksonville, Florida, United States

Site Status

Cardiovascular Research Center of South Florida

Miami, Florida, United States

Site Status

Research One

Orlando, Florida, United States

Site Status

Cardiology Partners Clinical Research Institute

Wellington, Florida, United States

Site Status

Fox Valley Clinical Research Center, LLC

Aurora, Illinois, United States

Site Status

Research Integrity, LLC

Owensboro, Kentucky, United States

Site Status

Louisiana Heart Center

Covington, Louisiana, United States

Site Status

Louisiana Heart Center

Slidell, Louisiana, United States

Site Status

Androscroggin Cardiology Associates DBA Maine Research Associates

Auburn, Maine, United States

Site Status

Delmarva Heart Research Foundation, Inc

Salisbury, Maryland, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Cardiovascular Imaging Technologies

Kansas City, Missouri, United States

Site Status

Dr. Michael Sacher

Massapequa, New York, United States

Site Status

Columbia University Medical Center

New York, New York, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Heritage Cardiology

Camp Hill, Pennsylvania, United States

Site Status

University of Pittsburgh Medical Center Cardiovascular Institute

Pittsburgh, Pennsylvania, United States

Site Status

Kore Cardiovascular Research

Jackson, Tennessee, United States

Site Status

East Texas Cardiology PA

Houston, Texas, United States

Site Status

Mercury Medical, LLC

San Antonio, Texas, United States

Site Status

University of Ottawa Heart Institute

Ottawa, Ontario, Canada

Site Status

ECOGENE-21 Clinical Trial Center, Chicoutimi Hospital

Chicoutimi, Quebec, Canada

Site Status

Montreal Heart Institute

Montreal, Quebec, Canada

Site Status

Chum Hotel Dieu

Montreal, Quebec, Canada

Site Status

University Hospital Kralovske Vinohrady

Prague, , Czechia

Site Status

University Hospital Motol

Prague, , Czechia

Site Status

Turku University Hospital

Turku, , Finland

Site Status

Barzilai Medical Center

Ashkelon, , Israel

Site Status

Soroka Medical Center

Beersheba, , Israel

Site Status

Rambam Health Care Campus

Haifa, , Israel

Site Status

Kaplan Medical Center

Rehovot, , Israel

Site Status

Assuta MC

Tel Aviv, , Israel

Site Status

"Federico II" University

Naples, , Italy

Site Status

Federico II University

Naples, , Italy

Site Status

National University Health System

Singapore, , Singapore

Site Status

National Heart Centre Singapore

Singapore, , Singapore

Site Status

Northwick Park Hospital, Watford Road

Middlesex, , United Kingdom

Site Status

Countries

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United States Canada Czechia Finland Israel Italy Singapore United Kingdom

Other Identifiers

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GS-US-259-0103

Identifier Type: -

Identifier Source: org_study_id

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