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Ranolazine, a piperazine derivative, is a novel antianginal agent thought to work by blocking intracellular sodium and calcium overload that occurs during myocardial ischemia. In a randomized, double-blind, placebo-controlled trial, researchers evaluated ranolazine’s effect on cardiovascular outcomes in 6560 patients who had angina at rest (>10 minutes within the prior 48 hours) and at least one indicator of moderate-to-high risk for death or recurrent ischemic events (elevated biomarkers of necrosis, ST depression ≥0.1 mV, diabetes, or TIMI risk score ≥3). Ranolazine or placebo was administered intravenously for 12 to 96 hours and then orally for the remainder of the study (median follow-up, 348 days). All patients also received standard t…