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Posted by on Oct 24, 2018 in Coronary artery disease | 0 comments

In a nutshell

This study investigated if ranolazine (Ranexa) improved angina symptoms and blood flow. They found that ranolazine improved angina symptoms and blood flow in patients with reduced coronary (blood vessels that supply the heart) flow.

Some background

Angina is the term for chest pain. Chest pain usually arises when the flow of blood to the heart is reduced. Reduced blood flow leads to a reduced oxygen supply to the heart muscle (ischemia). In some cases, angina is caused by coronary artery disease (CAD; e.g. blockages in the arteries that supply the heart). In other cases, it is unclear what the cause of angina is. Some patients with angina do not have any symptoms of CAD.

Treating angina is important to reduce pain and prevent adverse outcomes (e.g. heart attack). In angina, there is a build-up of calcium in heart cells. This leads to the wall of the heart becoming hardened and stressed. This leads to reduced blood flow. Ranolazine is a drug that blocks the flow of sodium in heart cells and prevents calcium building up. The leads to an improved blood flow to the heart. The effectiveness of ranolazine in patients with angina remains under investigation.

Methods & findings

This study included 81 patients with angina with minimal or no CAD. Patients were assigned to eitheranolazine or placebo (inactive drug) for 2 weeks. Patients took 500 mg ranolazine once daily for the first week and 1000 mg for the second week. Following a 2-week washout (no treatment), patients swapped to either ranolazine or placebo for another 2 weeks. Angina symptoms were the main outcome of interest. Cardiac flow reserve (CFR) was measured to determine the supply of blood to the heart. 

Angina symptoms and their frequency were improved in patients that took ranolazine. This improvement was only observed in patients with a CFR less than 2.5. Side effects of ranolazine treatment included arm shaking, wheezing, and nausea.

The bottom line

The authors concluded that short-term ranolazine treatment improved angina symptoms and blood flow in patients with a CFR less than 2.5.

The fine print

The patients in this study took ranolazine for a relatively short period. Long-term studies are needed to determine if ranolazine is appropriate to treat angina.

What’s next?

If you have any concerns regarding angina treatment, please consult with your physician.

Published By :

International Journal of Cardiology

Date :

Oct 02, 2018

Original Title :

Late sodium channel blockade improves angina and myocardial perfusion in patients with severe coronary microvascular dysfunction: Women’s Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction ancillary study.

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