Ranolazine, the first of a new class of compounds known as partial fatty acid oxidation (pFOX) inhibitors, may offer a new therapeutic approach for chronic angina pectoris. New study data have shown that, compared with standard antianginal therapy, the addition of ranolazine significantly increased exercise time by 24 seconds. The efficacy of ranolazine when used in combination with the β-blocker atenolol, or the calcium antagonists diltiazem or amlodipine, was demonstrated in results from the phase III Combination Assessment of Ranolazine in Stable Angina (CARISA) trial presented at the Scientific Sessions of the American Heart Association [Anaheim, US; November 2001]. If approved, ranolazine will represent the first new class of antianginal agents in 20 years.