Update on ranolazine in the management of angina
J Nicolás Codolosa,1 Subroto Acharjee,1 Vincent M Figueredo1,2 1Einstein Center for Heart and Vascular Health, Einstein Medical Center, 2Jefferson Medical College, Philadelphia, PA, USA Abstract: Mortality rates attributable to coronary heart disease have declined in recent years, possib...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2014-06-01
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| Series: | Vascular Health and Risk Management |
| Online Access: | http://www.dovepress.com/update-on-ranolazine-in-the-management-of-angina-a17328 |
| _version_ | 1811251268231888896 |
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| author | Codolosa JN Acharjee S Figueredo VM |
| author_facet | Codolosa JN Acharjee S Figueredo VM |
| author_sort | Codolosa JN |
| collection | DOAJ |
| description | J Nicolás Codolosa,1 Subroto Acharjee,1 Vincent M Figueredo1,2 1Einstein Center for Heart and Vascular Health, Einstein Medical Center, 2Jefferson Medical College, Philadelphia, PA, USA Abstract: Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA) remains prevalent, and the goal of treatment is control of symptoms and reduction in cardiovascular events. Ranolazine is a selective inhibitor of the late sodium current in myocytes with anti-ischemic and metabolic properties. It was approved by the US Food and Drug Administration in 2006 for use in patients with CSA. Multiple, randomized, placebo-controlled trials have shown that ranolazine improves functional capacity and decreases anginal episodes in CSA patients, despite a lack of a significant hemodynamic effect. Ranolazine did not improve cardiovascular mortality or affect incidence of myocardial infarction in the MERLIN (Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndrome)-TIMI (Thrombolysis In Myocardial Infarction) 36 trial, but significantly decreased the incidence of recurrent angina. More recently, ranolazine has been shown to have beneficial and potent antiarrhythmic effects, both on supraventricular and ventricular tachyarrhythmias, largely due to its inhibition of the late sodium current. Randomized controlled trials testing these effects are underway. Lastly, ranolazine appears to be cost-effective due to its ability to decrease angina-related hospitalizations and improve quality of life. Keywords: ranolazine, chronic stable angina, coronary artery disease |
| first_indexed | 2024-04-12T16:17:55Z |
| format | Article |
| id | doaj.art-19e5a4c5833149d3b9630a6a4f9084c6 |
| institution | Directory Open Access Journal |
| issn | 1178-2048 |
| language | English |
| last_indexed | 2024-04-12T16:17:55Z |
| publishDate | 2014-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Vascular Health and Risk Management |
| spelling | doaj.art-19e5a4c5833149d3b9630a6a4f9084c62022-12-22T03:25:40ZengDove Medical PressVascular Health and Risk Management1178-20482014-06-012014default35336217328Update on ranolazine in the management of anginaCodolosa JNAcharjee SFigueredo VMJ Nicolás Codolosa,1 Subroto Acharjee,1 Vincent M Figueredo1,2 1Einstein Center for Heart and Vascular Health, Einstein Medical Center, 2Jefferson Medical College, Philadelphia, PA, USA Abstract: Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA) remains prevalent, and the goal of treatment is control of symptoms and reduction in cardiovascular events. Ranolazine is a selective inhibitor of the late sodium current in myocytes with anti-ischemic and metabolic properties. It was approved by the US Food and Drug Administration in 2006 for use in patients with CSA. Multiple, randomized, placebo-controlled trials have shown that ranolazine improves functional capacity and decreases anginal episodes in CSA patients, despite a lack of a significant hemodynamic effect. Ranolazine did not improve cardiovascular mortality or affect incidence of myocardial infarction in the MERLIN (Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndrome)-TIMI (Thrombolysis In Myocardial Infarction) 36 trial, but significantly decreased the incidence of recurrent angina. More recently, ranolazine has been shown to have beneficial and potent antiarrhythmic effects, both on supraventricular and ventricular tachyarrhythmias, largely due to its inhibition of the late sodium current. Randomized controlled trials testing these effects are underway. Lastly, ranolazine appears to be cost-effective due to its ability to decrease angina-related hospitalizations and improve quality of life. Keywords: ranolazine, chronic stable angina, coronary artery diseasehttp://www.dovepress.com/update-on-ranolazine-in-the-management-of-angina-a17328 |
| spellingShingle | Codolosa JN Acharjee S Figueredo VM Update on ranolazine in the management of angina Vascular Health and Risk Management |
| title | Update on ranolazine in the management of angina |
| title_full | Update on ranolazine in the management of angina |
| title_fullStr | Update on ranolazine in the management of angina |
| title_full_unstemmed | Update on ranolazine in the management of angina |
| title_short | Update on ranolazine in the management of angina |
| title_sort | update on ranolazine in the management of angina |
| url | http://www.dovepress.com/update-on-ranolazine-in-the-management-of-angina-a17328 |
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