Emerging clinical role of ranolazine in the management of angina

摘要: Chronic stable angina is an exceedingly prevalent condition with tremendous clinical, social, and financial implications. Traditional medical therapy for consists of beta- blockers, calcium channel nitrates. These agents decrease myocardial oxygen demand ischemia by reducing heart rate, lowering blood pressure, and/or optimizing ventricular loading characteristics. Unique in its mechanism action, ranolazine the first new antianginal agent approved use US chronic over 25 years. By inhibiting late inward sodium current (I Na ), prevents pathologic intracellular accumulation that leads to ischemia, dysfunction, electrical instability. Ranolazine has been proven multiple clinical trials reduce symptoms safely effectively improve exercise tolerance patients symptomatic coronary disease. benefits occur without reduction rate pressure or increased mortality. Although prolongs QT c , experimental data indicate may actually be antiarrhythmic. In a large acute syndrome trial, reduced incidence supraven- tricular tachycardia, new-onset atrial fibrillation, bradycardic events. Additional under investigation include reductions glycosylated hemoglobin levels improved left function. medication disease, should considered as initial those hypotension bradycardia.