All CCBs cause similar coronary vasodilation and are preferred in vasospastic angina.253 They also alleviate ischemia due to obstructive CAD by decreasing heart rate and BP. Verapamil and diltiazem decreased reinfarction in patients without LV dysfunction in some248,249,254 but not all studies.255,256 Verapamil may be beneficial in reducing long-term events after AMI in hypertensive patients without LV dysfunction250 and in patients with MI and HF receiving an ACE inhibitor.257 Immediate-release nifedipine causes a dose-related increase in mortality in patients with CAD and harm in ACS and is not recommended for routine use in patients with ACS.251,258 Long- acting preparations may be useful in older patients with systolic There are no significant trial data on efficacy of amlodipine or felodipine in patients with NSTE-ACS. See Online Data Supplement 12 for additional information on CCBs. Short-acting dihydropyridine calcium channel antagonists should be avoided. Amsterdam et al 2014 AHA/ACC NSTE-ACS Guideline e363 4.1.2.5. Other Anti-Ischemic Interventions Ranolazine Ranolazine is an antianginal medication with minimal effects on heart rate and BP.260,261 It inhibits the late inward sodium cur- rent and reduces the deleterious effects of intracellular sodium and calcium overload that accompany myocardial ischemia.262 Ranolazine is currently indicated for treatment of chronic angina. 