Effects of the Antianginal Drugs Ranolazine, Nicorandil, and Ivabradine on Coronary Microvascular Function in Patients With Nonobstructive Coronary Artery Disease: A Meta-analysis of Randomized Controlled Trials

Zhu, Houyong; Xu, Xiaoqun; Fang, Xiaojiang; Zheng, Jianwu; Zhao, Qian; Chen, Tielong; Huang, Jinyu

doi:10.1016/j.clinthera.2019.08.008

Cited by 26 publications

(13 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Their study also suggested that patients with a reduced baseline CFR (< 2.5) were most likely to benefit from ranolazine, with significant improvements in myocardial perfusion (P ¼ 0.014) and angina frequency (P ¼ 0.027). 5 This has also recently been indicated by a comprehensive meta-analysis of Zhu et al, 30 which implicated an enhanced efficacy of ranolazine in CMD subgroups with a baseline CFR < 2.5 or a global quantitative myocardial perfusion reserve index < 2.…”

Section: Discussionmentioning

confidence: 72%

Efficacy of Ranolazine for Treatment of Coronary Microvascular Dysfunction—A Systematic Review and Meta-analysis of Randomized Trials

et al. 2021

View full text Add to dashboard Cite

Background: Coronary microvascular dysfunction (CMD) is a common cause of angina and exercise intolerance in patients without obstructive coronary artery disease. The efficacy of ranolazine, a late sodium channel blocker, in patients with symptomatic obstructive coronary artery disease is well established. To evaluate the efficacy of ranolazine in CMD, we performed a systematic review and meta-analysis of randomized studies. Methods: MEDLINE, EMBASE, Cochrane CENTRAL, and conference abstracts were searched from January 1975 to March 2020. Randomized trials evaluating ranolazine in patients with CMD were CJC Open 3 (2021) 101e108

show abstract

Section: Discussionmentioning

confidence: 72%

Efficacy of Ranolazine for Treatment of Coronary Microvascular Dysfunction—A Systematic Review and Meta-analysis of Randomized Trials

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In this case, our results could also be explained thanks to other pharmacodynamic mechanisms that overlap with the anti-ischemic mechanism on diseased epicardial vessels. In recent years, some studies showed how ranolazine may be an effective treatment option also for the symptomatic management of microvascular angina [ 20 , 21 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Ranolazine for the Treatment of Residual Angina beyond the Percutaneous Coronary Revascularization

Calcagno

Infusino

Salvi

et al. 2020

JCM

View full text Add to dashboard Cite

Introduction. Despite a successful percutaneous coronary intervention (PCI), several studies reported that the recurrence of angina after revascularization, even complete, is a particularly frequent occurrence in the first year after PCI. Methods. The aim was to evaluate the efficacy of treatment with ranolazine in addition to conventional anti-ischemic therapy in patients who underwent coronary angiography for persistent/recurrent angina after PCI and residual ischemia only due to small branches not suitable for further revascularization. Forty-nine consecutive patients were included in our registry, adding the ranolazine (375 mg b.i.d) to optimal medical therapy (OMT). The Exercise ECG Test (EET) was performed in all patients before to start the therapy (baseline BL) and at 30 days (T1) after enrollment. Results. The average duration of the exercise was increased after the therapy with ranolazine comparing to baseline (RG 9’1” ± 2’ versus BL 8’10” ± 2’, p = 0.01). Seven (14.3%) patients after receiving ranolazine had not crossed the threshold of six minutes (75 watts) compared to 20 (40.8%) of BL (p = 0.0003). Stress angina appeared more frequently at BL than at 30 days (T1 4.1% versus BL 16.3%, p = 0.04) as well as exercise-induced arrhythmias (BL 30.6% versus T1 14.3%, p = 0.05). Conclusions. The addition of ranolazine to standard anti-ischemic therapy showed a significant improvement in EET results after one month of therapy, including reduced exercise angina, increased exercise tolerance, and reduced exercise arrhythmias.

show abstract

“…Ranolazine is an antianginal drug that does not affect the main hemodynamically parameters of the cardiovascular system, but inhibits the activity of sodium in cardiomyocytes in ischemic conditions as a result, this effect reduces intracellular sodium and calcium overload. This mechanism of action improves myocardial relaxation, diastolic function and has a positive effect on myocardial contractility and perfusion [8].…”

Section: Introductionmentioning

confidence: 95%

Impact of ranolazine on exercise tolerance and arrhythmias in patients with INOCA

Tseluyko

Pylova

2021

SR:MS

View full text Add to dashboard Cite

The aim of the study to evaluate the effect of supplementation of basic therapy by ranolazine in patients with INOCA on exercise test parameters and Holter ECG monitoring. Materials and methods. 53 patients with stable coronary heart disease were examined, including 18 men (33.9 %) and 35 (66 %) women, the average age of patients was 57 (±9.68) years. According to the results of coronary angiography all patients had non-obstructive coronary arteries. In addition to physical and laboratory examination, bicycle ergometry, Holter ECG monitoring and echocardiography were included in the examination of patients. Patients were divided into 2 groups: group I - patients who in addition to standard therapy received ranolazine at a dose of 1000 mg twice a day for 6 months, and group II patients with standard coronary heart disease therapy. After 6 months from the beginning of the observation an objective examination, echocardiography, exercise test, Holter ECG monitoring were repeated. Results. The study found that patients receiving ranolazine in addition to standard therapy had a statistically significant increase in exercise duration after 6 months compared with baseline and group II. Before treatment in group I, the duration of the exercise test was 356.51±180.24s, and after treatment 414.32±142.10s (p=0.03). In group II, the duration of the test before treatment was 361.4±160.24 c, and after 380.5±152.2 s (p=0.15). It was also found that the duration of the test differed significantly in group I after treatment of patients from group II after treatment of patients with a standard treatment regimen (p=0.04). According to the results of Holter ECG monitoring in group I found a positive effect of ranolazine on the frequency of ventricular arrhythmias: before treatment n=1142 [30; 2012], after treatment n=729 [23; 1420], while in group II a significant difference between the number of extrasystoles before treatment and after not detected (n=1026 [17; 1920], n=985 [15; 1680], respectively) p=0.18. Conclusions. The addition of ranolazine to the basic therapy of patients with non-obstructive coronary arteries disease helps to increase exercise tolerance (according to the loading stress test) and contributes to a significant reduction in the number of ventricular arrhythmias (according to Holter-ECG) compared with both baseline and group II

show abstract

Effects of the Antianginal Drugs Ranolazine, Nicorandil, and Ivabradine on Coronary Microvascular Function in Patients With Nonobstructive Coronary Artery Disease: A Meta-analysis of Randomized Controlled Trials

Cited by 26 publications

References 45 publications

Efficacy of Ranolazine for Treatment of Coronary Microvascular Dysfunction—A Systematic Review and Meta-analysis of Randomized Trials

Efficacy of Ranolazine for Treatment of Coronary Microvascular Dysfunction—A Systematic Review and Meta-analysis of Randomized Trials

The Role of Ranolazine for the Treatment of Residual Angina beyond the Percutaneous Coronary Revascularization

Impact of ranolazine on exercise tolerance and arrhythmias in patients with INOCA

Contact Info

Product

Resources

About