The rationale of MIDA trial is to determine efficacy and tolerability of ranolazine molecule among Pakistan population and obtain firsthand knowledge about the molecule ranolazine.

Inclusion Criteria:

• Patients with diagnosis of coronary artery disease (CAD)

  • Patients present with the symptoms of stable angina after withdrawn from other antianginal drugs and given the required background therapy for at least 7 days will be qualified for entering this study and performing 1st ETT qualifying test
  • Patients developed exercise-induced ECG ischemiai during two qualifying exercise treadmill testsii.
  • Willing and able to provide a written informed consent

Exclusion Criteria:

• • Factors that might compromise ECG or ETT interpretation

  • Patients with resting ST-segment depression ≥ 1mm in any lead

  • Left bundle-branch block

  • Patients implanted with pacemaker

  • Patients under Digitalis therapy

    • Patients with family history of (or congenital) long QT syndrome
    • Patients with congenital heart disease
    • Patients with uncorrected valvular heart disease
    • Patients with unstable angina, or MI, or coronary revascularization procedure ≤ 2 months prior enter this study
    • Female who is pregnant/lactating or planning to be pregnant, or female of childbearing potential* who is not using medically recognized method of contraception

  • *Other than those who have been surgically sterilized (defined as having undergone hysterectomy or bilateral oophorectomy or bilateral salpingectomy; tubal ligation alone is not considered sufficient) or one year post-menopausal.

    • Patients are under any one of the following conditions:

  • New York Heart Association (NYHA) Class III or Class IV congestive heart failure (CHF)

  • QTc > 450 msec at screening

  • Active myocarditis, pericarditis, hypertrophic cardiomyopathy

  • Uncontrolled hypertension (defined as SBP > 180 mmHg) Voltage criteria for left ventricular hypertrophy in the absence of repolarization abnormalities will not be exclusion criteria

    • Use of any investigational product ≤ 4 weeks prior to screening
    • Patients with severe hepatic disease (e.g., liver cirrhosis)
    • Patients with impaired renal function (defined as serum Cr >1.5 mg/dl)
    • Patients with any condition or disease which is considered not suitable for this study by investigator