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Int J Cardiol. 2017 Jan 15;227:556-564. doi: 10.1016/j.ijcard.2016.10.102. Epub 2016 Nov 2.

Role of Ranolazine in cardiovascular disease and diabetes: Exploring beyond angina.

Author information

1
Cleveland Clinic, Cleveland, OH, USA.
2
Department of Internal Medicine, St. Vincent Charity Medical Center, A Teaching Affiliate of Case Western Reserve University, Cleveland, OH, USA. Electronic address: raktimghoshmd@gmail.com.
3
Department of Internal Medicine, St. Vincent Charity Medical Center, A Teaching Affiliate of Case Western Reserve University, Cleveland, OH, USA.
4
IPGMER, Kolkata, India.
5
Department of Cardiovascular Medicine, St. Vincent Charity Medical Center, A Teaching Affiliate of Case Western Reserve University, Cleveland, OH, USA.

Abstract

Ranolazine was FDA approved for chronic angina in 2006. Since then, there has been extensive research involving this drug. The mechanism of action, debatable at the time of approval, has been demonstrated. Ranolazine acts via inhibition of late sodium channel current in the myocardium. This acts by lowering abnormally high cytosolic calcium levels. Other possible clinical applications of Ranolazine have also been explored. Out of many lines of investigation, its effects in atrial fibrillation, especially post-CABG and recurrent atrial fibrillation show promise. It has also shown definite HbA1c lowering effects when used in diabetics with coronary artery disease. Other possible indications for the drug include pulmonary arterial hypertension, diastolic dysfunction and chemotherapy-induced cardiotoxicity. This review aims to summarize major research regarding Ranolazine in potential applications beyond chronic angina. There are few dedicated large, randomized, phase III trials exploring the newer effects of Ranolazine. There are a few such trials underway, but more are needed.

KEYWORDS:

Angina; Atrial fibrillation; Diabetes; Diastolic dysfunction; Pulmonary arterial hypertension; Ranolazine

PMID:
27838121
DOI:
10.1016/j.ijcard.2016.10.102
[Indexed for MEDLINE]

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