MARINARanolazine's Impact on Coronary Microvasculature in Non-Obstructive Atherosclerosis

Heart disease is a leading cause of death worldwide, often involving issues with the large heart arteries. However, this study focuses on a less understood area - the very small heart arteries, known as the coronary microvasculature. This 'base of the iceberg' of cardiovascular disease is believed to contribute to reduced blood flow, symptoms, and negative outcomes. The study aims to better understand how dysfunction in these small arteries leads to such issues, particularly in individuals with non-obstructive atherosclerosis. A medicine called Ranolazine, approved by the U.S Food and Drug Administration to help with angina (chest pain), is being investigated in this study, as its effects on the coronary microvasculature are not yet fully understood. During this study, participants receive either Ranolazine or a placebo for 12 weeks. The impact of the treatment is measured using the Seattle Angina Questionnaire, specifically looking at changes in the frequency of angina episodes. This questionnaire scores health on a scale from 0 to 100, with higher scores indicating better health. A positive change in the angina frequency score suggests that participants are experiencing fewer angina episodes at the end of the 12 weeks compared to the start of the study. The study uses reliable diagnostic tools that do not rely solely on imaging, but also include hemodynamic measurements such as coronary flow reserve and hyperemic microcirculatory resistance, which are taken in a cardiac catheterization laboratory.