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New oral nitric oxide-dependent medications for patients with coronary artery disease who have persistent angina pectoris.

Ranolazine and trimerazidine are relatively new medications used to relieve chest pain in patients with stable angina pectoris. Both affect patients with angina independent of the reduction of heart rate or blood pressure. The recent study published in this journal describes a prospective double-blind study that studied the effects of both medications on the endothelial function of patients with coronary artery disease (CAD) who had stable angina pectoris [1]. Both medications improved flowmediated diameter percent change (a nitric oxidedependent pathway) and the flow-independent diameter percent change (a nitroglycerin-induced dilation of the artery, which is independent of the endothelial/nitric oxide pathway).