Impact of Ranolazine in Blood Markers in Women With Angina and Metabolic Syndrome

Inclusion Criteria: * Patients with chronic stable angina (\> 3 months) on evidence based adequate therapy * Evidence of stable coronary artery disease by any of these: * MI, PCI or CABG \> 30 days prior to enrollment or * Angiography showing \> 50% stenosis in major vessel, branch or bypass graft \> 30 days of enrollment or * Abnormal stress MPI nuclear study, or DBA stress echo where the decision has been to treat medically and where angina has remained stable for \>= 3 months * Evidence of the Metabolic Syndrome: As defined by ATP III criteria i.e 3/5 of following Abdominal circumference F \> 88 cm (35 in), M \> 102 cm (40 in) Hypertriglyceridemia ≥ 150 mg/dl HDL F \< 50 mg/dl M \< 40 mg/dl Blood Pressure ≥130/85 Fasting Glucose ≥100 mg/dl For reproductive age women, a negative urine pregnancy test is required if all other inclusion criteria are met. Exclusion Criteria: * Exclusion of patients with contraindications to use of RANEXA, including patients on CYP3A4 inducers/potent inhibitors, and patients with liver cirrhosis. * Exclusion of Patients with CrCl \< 30 mL/min * Limit dose of RANEXA to 500mg BID in patients on concurrent diltiazem/ verapamil * Limit concurrent simvastatin to 20 mg/day * Limit concurrent metformin to 1700 mg/day Additional Exclusion * Patients with variable -inconsistent symptoms * Patients with unstable coronary artery disease or revascularization within 30 days of enrollment. * Patients who have known severe liver disease. * Patients already receiving maximal ranolazine therapy for more than 4 weeks * Presence of diabetes (AIC≥ 6.5 and /or on insulin therapy or anti-diabetic medication other than metformin) unstable hypothyroidism, active infection, active cancer (or ongoing chemotherapy and/or radiation within a year who are not on remission) and/or recent major surgery or illness. * Patients with any contraindication to ranolazine see above * Women of reproductive age are excluded if they are planning to become pregnant in the next 6 -12 months after randomization. * Patients who are pregnant or lactating * Documented allergic reaction to ranolazine in the past. * Unexplained prolongation of the QTc \> 500 milliseconds. * Current or planned co-administration of moderate CYP3A inhibitors (eg, diltiazem, verapamil, aprepitant, erythromycin, fluconazole, and grapefruit juice or grapefruit-containing products) is not a full contraindication, if meet inclusion criteria otherwise, these patients could be accepted in trial but dose will be limited to 500 mg BID as stated previously. * Current or planned co-administration of strong CYP3A inhibitors (eg, ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, and saquinavir) OR strong CYP3A inducers (eg, rifampin, rifabutin, rifapentine, phenobarbital, phenytoin,carbamazepine, and St. John's Wort) is a contraindication.