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Pharmacological Management of Chronic Stable Angina: Focus on Ranolazine

Giuseppe M C Rosano1,2,3, Cristiana Vitale4,5,6, Maurizio Volterrani5

  • 1Clinical Academic Group, St George's Hospital NHS Trust, Cranmer Terrace, London, SW17 0RE, UK. grosano@sgul.ac.uk.

Cardiovascular Drugs and Therapy
|July 16, 2016
PubMed

Insights

For chronic stable angina, percutaneous coronary intervention and anti-anginal drugs offer similar outcomes. Ranolazine effectively reduces symptoms and improves exercise tolerance in patients with inadequately controlled angina.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Stable ischemic heart disease management hinges on optimal anti-anginal therapy.
  • Percutaneous coronary intervention (PCI) and anti-anginal medications show comparable prognostic effectiveness for chronic stable angina.
  • Conventional anti-anginal agents demonstrate similar efficacy in improving ischemic symptoms and exercise parameters.

Purpose of the Study:

  • To evaluate the role of ranolazine as an adjunctive therapy for chronic stable angina.
  • To assess ranolazine's impact on exercise performance, angina frequency, and nitrate use.
  • To review ranolazine's safety profile and potential future applications.

Main Methods:

  • Review of clinical development programs for ranolazine.
  • Comparison of ranolazine's effects against placebo in patients with chronic stable angina.
  • Analysis of ranolazine's hemodynamic effects and tolerability.

Main Results:

  • Ranolazine significantly improves exercise performance and reduces angina symptoms compared to placebo.
  • The drug decreases the need for sublingual nitrate use in patients with chronic stable angina.
  • Ranolazine is well-tolerated and has a neutral effect on hemodynamics.

Conclusions:

  • Ranolazine is an effective non-hemodynamic anti-anginal agent for inadequately controlled chronic stable angina.
  • Beta-blockers may not benefit patients with preserved systolic function, even post-myocardial infarction.
  • Ranolazine shows promise for future therapeutic applications in cardiovascular and non-cardiovascular conditions.

Keywords:
AnginaCoronary artery diseaseHeartHeart failureIvabradineMyocardial infarctionPrognosisRanolazineTrimetazidine

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