Inclusion criteria:
The patient's age is 40 to 75 years.
The patient has had chronic angina for at least one month (at least two episodes of anginal pain or discomfort in the chest, jaw, shoulders, back, neck, or arms that is aggravated by activity or emotional stress and relieved by rest or sublingual nitroglycerin, and that occur on two separate days).
Patients with a documented history of coronary artery disease (including ≥60% stenosis of at least one major coronary artery on angiography, history of myocardial infarction, or stress-induced reversible ischemia as seen by radionucleotide imaging or echocardiography) and who have undergone angioplasty (percutaneous coronary intervention) at least 6 months after the procedure.
Patients with EF (ejection fraction) of at least 40 percent.
The patient is being treated with anti-ischemic drugs (beta blockers, calcium channel blockers, long-acting nitrates, ranolazine) for at least 2 weeks.
Patients for whom the use of ranolysin is safe and in accordance with the treatment protocol.
After explaining the procedure to the patient, consent must be obtained from the patient and his/her family.
Exclusion criteria:
A patient with stable angina who is being treated with nitrates at maximum dose (nitrocardin 6.4mg every 12 hours or once every 8 hours) and whose pain is still not controlled.
The patient has NYAH class 3 or 4 heart failure.
The patient has a history of myocardial infarction or unstable angina (pain lasting more than 15 to 20 minutes) within the last 2 months.
The patient has been referred to the center with acute myocardial infarction or active pericarditis.
The patient has undergone coronary artery bypass grafting (CABG) surgery or a decision has been made for CABG in the future.
Patients with a history of serious ventricular arrhythmias or QTc prolongation greater than 500 milliseconds.
The patient has a history of stroke or transient ischemic attacks within the last 6 months.
The patient has uncontrolled blood pressure.
The patient has liver disorder with clear clinical evidence (including liver cirrhosis).
The patient has severe renal dysfunction (GFR <30ml/min per 1.73m2) or is undergoing renal dialysis treatment.
Patients taking drugs that have severe drug interactions with ranolysin (such as ketoconazole, clarithromycin, CYP3A4 inhibitor drugs).
Patients who have not tolerated ranolysin in the past for any reason.
Patients with inability to cooperate with the study (such as cognitive or psychiatric disorders).
Pregnant or breastfeeding women.
1Patients who cannot participate during the study period due to non-medical reasons such as relocation.