Ranolazina en cardiopatía isquémica crónica: un factor protector frente a la fibrilación auricular de novo

Abstract

IntroductionRanolazine has shown to be effective in cases of angina in patients with chronic ischaemic heart disease. Recent studies have evaluated it as a drug to prevent electrical post-cardioversion, post-surgical or post-infarction atrial fibrillation. ObjectivesTo perform a long-term evaluation of de novo atrial fibrillation episodes in patients with chronic ischaemic heart disease and a new episode of unstable angina that are taking 350 or 500mg/12h of ranolazine, in comparison with usual treatment. MethodsAn observational, retrospective study was performed to compare the incidence of de novo atrial fibrillation in 77 consecutive patients with a diagnosis of non-revascularisable ischaemic heart disease and a new hospital admission due to acute coronary syndrome during the year 2013. These were compared with those that started with ranolazine and those on conventional treatment in the 12 months following the event. The detection of atrial fibrillation was based on its presence in a first electrocardiographic register. ResultsOf the 77 patients, 38 were started on ranolazine, with no differences as regards the baseline characteristics of the two populations. They had similar rates of classic cardiovascular risk factors, echocardiographic data, such as atrial size, or previous treatment employed. A de novo atrial fibrillation rate of 5.3% was observed in the patients treated with ranolazine, compared to 23.1% in the non-ranolazine group (P<.001). On analysing the sub-group of patients that had an atrial fibrillation in their follow-up, only not taking of ranolazine was significant (P<.001). ConclusionThe use of ranolazine in patients with non-revascularisable ischaemic heart disease could have a protective effect against the development of atrial fibrillation during a 12 months follow-up.