Related Experiment Video
Updated: May 8, 2026
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Ranolazine: effects on ischemic heart
Andrea Rognoni, Lucia Barbieri, Chiara Cavallino
1Coronary Care Unit and Catheterization Laboratory, "Maggiore della Carita" Hospital, Corso Mazzini 18, 28100 Novara, Italy. arognoni@hotmail.com.
Insights
Ranolazine, an antianginal drug, effectively treats chronic stable angina by improving exercise tolerance and reducing nitroglycerin use. It offers a safe therapeutic option for patients with persistent symptoms or intolerance to other treatments.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary artery disease (CAD) is a leading cause of death globally, with angina pectoris being a primary symptom causing emergency visits.
- Angina pectoris, characterized by chest discomfort, significantly impacts quality of life and functional capacity.
- Current treatments aim to alleviate symptoms, improve function, and enhance prognosis for angina patients.
Purpose of the Study:
- To evaluate the efficacy and safety of Ranolazine as an add-on therapy for symptomatic chronic stable angina.
- To assess Ranolazine's impact on exercise duration, angina episodes, and nitroglycerin use.
- To review Ranolazine's long-term effects on cardiovascular outcomes and arrhythmias.
Main Methods:
- Review of short-term and long-term clinical trials and patent research on Ranolazine.
- Analysis of Ranolazine's mechanism of action, specifically its inhibition of the late sodium current.
- Assessment of patient-reported outcomes, exercise parameters, and cardiovascular event rates.
Main Results:
- Ranolazine significantly improves exercise duration and time to angina, while reducing nitroglycerin consumption in chronic stable angina patients.
- In non-ST segment elevation acute coronary syndromes, Ranolazine did not alter cardiovascular death or myocardial infarction rates but reduced recurrent ischemia.
- Ranolazine is well-tolerated, with no increased risk of atrial or ventricular arrhythmias despite QTc interval prolongation.
Conclusions:
- Ranolazine is a valuable therapeutic option for patients with chronic stable angina who remain symptomatic despite optimal therapy or are intolerant to traditional anti-ischemic drugs.
- Its unique mechanism of action, targeting the late sodium current, provides antianginal benefits without affecting heart rate or blood pressure.
- Ranolazine demonstrates a favorable safety profile, making it a suitable choice for managing persistent angina symptoms.
Abstract:
Coronary artery disease is the major cause of mortality and morbidity in the industrialized countries; in the United States of America and in Europe, it is responsible for one of every six deaths per year. In the setting of ischemic heart disease, angina pectoris and chest pain, in particular, are the major causes of emergency department accesses. Angina pectoris is a clinical syndrome characterized by discomfort typically in the chest, neck, chin and left arm induced by physical exertion, emotional stress and cold and is relieved by rest or by taking of nitrates. The main targets of treatment of angina pectoris are to improve quality of life by reducing the frequency and the severity of symptoms, to increase functional capacity and to improve prognosis. Ranolazine is a recent antianginal drug with unique methods of action. It was approved by the US Food and Drug Administration in 2006 as add-on therapy in patients symptomatic for stable angina. With the inhibition of the late sodium current, Ranolazine protects against ion deregulation, prevents cellular calcium overload and the subsequent increase in diastolic tension without impacting heart rate and blood pressure. Short term clinical trials and patent research show that add on therapy with Ranolazine in patients with chronic stable angina significantly improves exercise duration, exercise time to angina and reduces the use of nitro glycerine. Long term clinical trials showed no significant differences in the rate of cardiovascular death and myocardial infarction in patients with non-ST segment elevation acute coronary syndromes but a reduction in terms of recurrent ischemia. Ranolazine is generally well tolerated and even if it increases the duration of QTc interval it is not associated with atrial and ventricular arrhythmias. Therefore Ranolazine represents a good therapeutic approach in patients with chronic stable angina still symptomatic, while on optimal anti-ischemic therapy, or intolerant to traditional anti-ischemic drugs.
Related Concept Videos
01:25Antianginal Drugs: Calcium Channel Blockers and Ranolazine
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
01:22Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
01:12Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...
01:20Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
01:24Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers