Management of Symptomatic Patients with Chronic Coronary Syndromes: A Case-based Review on the Role of Ranolazine

Coronary artery disease is the leading cause of premature death worldwide and the resulting chronic mismatch between myocardial oxygen supply and consumption may result in angina on exertion, one of the most common symptoms of chronic coronary syndrome. As the global population increases, along with the prevalence of risk factors, especially in Asia, the burden of angina is expected to rise. Experts are advocating for the rationalisation of angina management by moving away from traditional approaches towards individualisation of therapy based on the patient’s comorbidities and underlying mechanisms of angina. Ranolazine is an antianginal drug that inhibits the late sodium ion channel currents, resulting in anti-ischaemic and antianginal effects without haemodynamic effects. This review uses a case-based approach to demonstrate the clinical utility of ranolazine in the management of patients with chronic coronary syndrome.