Abstract
Chronic angina represents a major burden for public health systems because of its poor prognosis and its high treatment costs. Ranolazine is an emerging drug recently approved for the treatment of this disease. The main molecular mechanism underlying ranolazine-mediated beneficial effects has been identified as inhibition of the late Na+ current during the action potential, which potentially improves oxygen consumption, diastolic dysfunction and coronary blood flow. Moreover, this particular mechanism of action also confers on ranolazine a potential antiarrhythmic effect. The aim of this review is to update the evidence for ranolazine treatment in chronic angina and discuss its therapeutic perspectives based on the most recent clinical and experimental studies.
Highlights
Stable angina (SA) is one of the most common manifestations of coronary artery disease (CAD) [1]
The aim of this review is to explore the pathophysiological mechanisms of action of ranolazine and to update evidence from recent clinical trials on its efficacy and safety in SA
Since both mechanisms are coupled with an increased in the late Na+ current (INa), a pathophysiological rationale exists for the investigation of ranolazine for treating diastolic dysfunction and failure
Summary
Federico Carbonea,b, Fabrizio Montecuccoa,b, François Macha a Division of Cardiology, Foundation for Medical Research, Department of Medical Specialties, University of Geneva, Switzerland b Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino–IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
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