Key result
Ranolazine reduces the frequency of anginal attacks and improves exercise capacity in patients with chronic stable angina, with negligible effects on blood pressure and heart rate.
Ranolazine is an effective anti-anginal agent that works by inhibiting late sodium influx, offering symptom relief without hemodynamic effects.
May support ranolazine for chronic angina without BP effects; leaves open prospective validation in real-world cohorts.
Ranolazine is a novel drug approved for the treatment of chronic angina pectoris. In randomized trials, it significantly reduced the frequency of anginal attacks and the need for use of short-acting nitroglycerine. It improved exercise capacity and delayed onset of anginal symptoms or electrocardiographic signs of ischemia during exercise in patients with chronic stable angina. Unlike other drugs used for the treatment of chronic angina, ranolazine has negligible effects on blood pressure and heart rate. A major mechanism believed to contribute to this clinical efficacy is its inhibitory effect on late sodium influx during the cardiac action potential of cardiomyocytes, which is particularly important in ischemic or hypoxic conditions. Ranolazine thereby reduces intracellular sodium and calcium accumulation during ischemia, as shown in various animal research models. In this review we discuss the pharmacological profile of ranolazine and discuss the current and potential future applications in cardiovascular disease for this drug.
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Reffelmann et al. (2010) conducted a review in chronic angina pectoris. Ranolazine was evaluated. Ranolazine reduces the frequency of anginal attacks and improves exercise capacity in patients with chronic stable angina, with negligible effects on blood pressure and heart rate.
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