Anti-ischemic and pleiotropic effects of ranolazine in chronic coronary syndromes.

Athanasios Manolis, Manolis Kallistratos, Leonidas Poulimenos, Costas Thomopoulos

Journal: The American journal of the medical sciences 2024;367(3):155-159

PMID: 38072070

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Abstract

The vast majority of antianginal drugs decrease heart rate and or blood pressure levels or the inotropic status of the left ventricle to decrease myocardial oxygen consumption (MVO2) and thus anginal symptoms. Ranolazine presents a completely different mechanism of action, which reduces the sodium-dependent calcium overload inhibiting the late sodium current. Current European Society of Cardiology (ESC) guidelines for the management of angina in patients with chronic coronary symptoms recommend the use of several drugs such as ranolazine, b-blockers, calcium channel blockers, long-acting nitrates, ivabradine, nicorandil and trimetazidine for angina relief. However, ranolazine, in addition to symptom relief properties, is an antianginal drug showing favorable effects in decreasing the arrhythmic burden and in ameliorating the glycemic profile of these patients. In this review, we summarize the available data regarding the antianginal and pleiotropic effects of this drug.

Address: Metropolitan General Hospital, 2nd Cardiology Department, Athens, Greece.; Metropolitan General Hospital, 2nd Cardiology Department, Athens, Greece. Electronic address: [email protected].; Asklepeion General Hospital Cardiology Department, Voula, Athens, Greece.; Helena Venizelou Hospital, Cardiology Department, Athens, Greece.

DOI: 10.1016/j.amjms.2023.12.001

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MeSH Terms: Humans, Ranolazine, Cardiovascular Agents, Angina Pectoris, Ivabradine, Sodium