Abstract

Abstract Background Ranolazine currently is used to relief angina symptoms in patients with chronic coronary syndrome (CCS). Additional its anti-angina effect it has been showing antiarrhythmic effect by predominantly inhibiting late sodium and rapid potassium rectifier current. We aimed to assess the efficacy of ranolazine for the prevention of atrial fibrillation (AF) in high-risk patients older than 60 years with CCS at least >5 years and hypertension. Methods 264 older high-risk patients (>60 years) with CCS and hypertension were prospectively enrolled (mean age was 66 ± 11.5 years, male 48%). Among them 132 patients have received additional ranolazine to the standard therapy while control group patients (n = 132) have received only standard therapy. Mean follow-up period was 5.0 ± 4.6 years. All statistical analyzes was performed using one sample student t-test. Results Initial baseline characteristics of patients were not statistically different. During the follow-up period in 8.3 % (n = 11) of patents have occurred MACE (AMI, PCI, CABG, death) in ranolazine group vs. in 9.8% (n = 13) of patients in the control group (P > 0.05). During the follow-up AF (paroxysmal and persistent) was developed significantly lower in ranolizine group than standard group (respectively: 13.6 % vs.18 percentage; P < 0.05). Sinus rhythm was recovered in the higher percent of patients in ranolazine group than standard group after cardioversion (89% vs. 79%, P < 0.05). Conclusion: Adding ranolazine to the standard treatment seems to have a beneficial role for the prevention of AF in high-risk patients with CCS and hypertension.

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