Emerging clinical role of ranolazine in the management of angina
David S Vadnais, Nanette K WengerDivision of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USAAbstract: Chronic stable angina is an exceedingly prevalent condition with tremendous clinical, social, and financial implications. Traditional medical therapy for angina consists of be...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2010-10-01
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| Series: | Therapeutics and Clinical Risk Management |
| Online Access: | http://www.dovepress.com/emerging-clinical-role-of-ranolazine-in-the-management-of-angina-a5511 |
| _version_ | 1798029236178518016 |
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| author | David S Vadnais Nanette K Wenger |
| author_facet | David S Vadnais Nanette K Wenger |
| author_sort | David S Vadnais |
| collection | DOAJ |
| description | David S Vadnais, Nanette K WengerDivision of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USAAbstract: Chronic stable angina is an exceedingly prevalent condition with tremendous clinical, social, and financial implications. Traditional medical therapy for angina consists of beta-blockers, calcium channel blockers, and nitrates. These agents decrease myocardial oxygen demand and ischemia by reducing heart rate, lowering blood pressure, and/or optimizing ventricular loading characteristics. Unique in its mechanism of action, ranolazine is the first new antianginal agent approved for use in the US for chronic angina in over 25 years. By inhibiting the late inward sodium current (INa), ranolazine prevents pathologic intracellular calcium accumulation that leads to ischemia, myocardial dysfunction, and electrical instability. Ranolazine has been proven in multiple clinical trials to reduce the symptoms of angina safely and effectively and to improve exercise tolerance in patients with symptomatic coronary heart disease. These benefits occur without reduction in heart rate and blood pressure or increased mortality. Although ranolazine prolongs the QTc, experimental data indicate that ranolazine may actually be antiarrhythmic. In a large acute coronary syndrome clinical trial, ranolazine reduced the incidence of supraventricular tachycardia, ventricular tachycardia, new-onset atrial fibrillation, and bradycardic events. Additional benefits of ranolazine under investigation include reductions in glycosylated hemoglobin levels and improved left ventricular function. Ranolazine is a proven antianginal medication in patients with symptomatic coronary heart disease, and should be considered as an initial antianginal agent for those with hypotension or bradycardia.Keywords: chronic angina, myocardial ischemia, ranolazine, pharmacotherapy, antianginal, sodium current |
| first_indexed | 2024-04-11T19:22:02Z |
| format | Article |
| id | doaj.art-4dcb0f1711a44da3bc63ae863466dd99 |
| institution | Directory Open Access Journal |
| issn | 1176-6336 1178-203X |
| language | English |
| last_indexed | 2024-04-11T19:22:02Z |
| publishDate | 2010-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Therapeutics and Clinical Risk Management |
| spelling | doaj.art-4dcb0f1711a44da3bc63ae863466dd992022-12-22T04:07:17ZengDove Medical PressTherapeutics and Clinical Risk Management1176-63361178-203X2010-10-012010default517530Emerging clinical role of ranolazine in the management of anginaDavid S VadnaisNanette K WengerDavid S Vadnais, Nanette K WengerDivision of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USAAbstract: Chronic stable angina is an exceedingly prevalent condition with tremendous clinical, social, and financial implications. Traditional medical therapy for angina consists of beta-blockers, calcium channel blockers, and nitrates. These agents decrease myocardial oxygen demand and ischemia by reducing heart rate, lowering blood pressure, and/or optimizing ventricular loading characteristics. Unique in its mechanism of action, ranolazine is the first new antianginal agent approved for use in the US for chronic angina in over 25 years. By inhibiting the late inward sodium current (INa), ranolazine prevents pathologic intracellular calcium accumulation that leads to ischemia, myocardial dysfunction, and electrical instability. Ranolazine has been proven in multiple clinical trials to reduce the symptoms of angina safely and effectively and to improve exercise tolerance in patients with symptomatic coronary heart disease. These benefits occur without reduction in heart rate and blood pressure or increased mortality. Although ranolazine prolongs the QTc, experimental data indicate that ranolazine may actually be antiarrhythmic. In a large acute coronary syndrome clinical trial, ranolazine reduced the incidence of supraventricular tachycardia, ventricular tachycardia, new-onset atrial fibrillation, and bradycardic events. Additional benefits of ranolazine under investigation include reductions in glycosylated hemoglobin levels and improved left ventricular function. Ranolazine is a proven antianginal medication in patients with symptomatic coronary heart disease, and should be considered as an initial antianginal agent for those with hypotension or bradycardia.Keywords: chronic angina, myocardial ischemia, ranolazine, pharmacotherapy, antianginal, sodium currenthttp://www.dovepress.com/emerging-clinical-role-of-ranolazine-in-the-management-of-angina-a5511 |
| spellingShingle | David S Vadnais Nanette K Wenger Emerging clinical role of ranolazine in the management of angina Therapeutics and Clinical Risk Management |
| title | Emerging clinical role of ranolazine in the management of angina |
| title_full | Emerging clinical role of ranolazine in the management of angina |
| title_fullStr | Emerging clinical role of ranolazine in the management of angina |
| title_full_unstemmed | Emerging clinical role of ranolazine in the management of angina |
| title_short | Emerging clinical role of ranolazine in the management of angina |
| title_sort | emerging clinical role of ranolazine in the management of angina |
| url | http://www.dovepress.com/emerging-clinical-role-of-ranolazine-in-the-management-of-angina-a5511 |
| work_keys_str_mv | AT davidsvadnais emergingclinicalroleofranolazineinthemanagementofangina AT nanettekwenger emergingclinicalroleofranolazineinthemanagementofangina |