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Effects of ranolazine on ischemic threshold, coronary sinus blood flow, and myocardial metabolism in coronary artery disease.
Cardiovasc Drugs Ther. 1997 Jul; 11(3):479-84.CD

Abstract

Cytoprotection or metabolic modulation is a new principle in the treatment of angina pectoris. The effect of ranolazine (a cytoprotective drug) on ischemic threshold, coronary sinus blood flow, and myocardial metabolism was evaluated by means of two pacing sequences in nine male patients with coronary artery disease (CAD) and in eight male controls. Ranolazine was given as an intravenous bolus followed by continuous infusion; the mean total dose was 32.7 mg and 31.7 mg in patients and controls, respectively. Angina pectoris was relieved in two patients after ranolazine but pacing time to pain was unchanged in the remaining patients. Maximal ST depression was lower (p = 0.02), but pacing time to maximal and to 1-mm ST depression remained unchanged after the drug. Ranolazine had no overall influence on coronary sinus blood flow, cardiac oxygen consumption, blood pressure, and heart rate. Cardiac uptake of free fatty acids (FFA) was reduced (p = 0.01), and net uptakes of glucose (p = 0.07) and lactate (p = 0.06) tended to be lower after ranolazine in CAD patients and controls. Ranolazine had no direct influence on cardiac exchange of glutamate, alanine, and citrate or on the arterial concentration of any metabolite. In the present study ranolazine had minimal clinical effects. A decrease in myocardial FFA utilization, however, allows greater myocardial glucose oxidation, which may increase the energy production in relation to oxygen availability.

Authors+Show Affiliations

Department of Cardiology, Aarhus University Hospital, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9310277

Citation

Bagger, J P., et al. "Effects of Ranolazine On Ischemic Threshold, Coronary Sinus Blood Flow, and Myocardial Metabolism in Coronary Artery Disease." Cardiovascular Drugs and Therapy, vol. 11, no. 3, 1997, pp. 479-84.
Bagger JP, Bøtker HE, Thomassen A, et al. Effects of ranolazine on ischemic threshold, coronary sinus blood flow, and myocardial metabolism in coronary artery disease. Cardiovasc Drugs Ther. 1997;11(3):479-84.
Bagger, J. P., Bøtker, H. E., Thomassen, A., & Nielsen, T. T. (1997). Effects of ranolazine on ischemic threshold, coronary sinus blood flow, and myocardial metabolism in coronary artery disease. Cardiovascular Drugs and Therapy, 11(3), 479-84.
Bagger JP, et al. Effects of Ranolazine On Ischemic Threshold, Coronary Sinus Blood Flow, and Myocardial Metabolism in Coronary Artery Disease. Cardiovasc Drugs Ther. 1997;11(3):479-84. PubMed PMID: 9310277.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of ranolazine on ischemic threshold, coronary sinus blood flow, and myocardial metabolism in coronary artery disease. AU - Bagger,J P, AU - Bøtker,H E, AU - Thomassen,A, AU - Nielsen,T T, PY - 1997/7/1/pubmed PY - 1997/10/6/medline PY - 1997/7/1/entrez SP - 479 EP - 84 JF - Cardiovascular drugs and therapy JO - Cardiovasc Drugs Ther VL - 11 IS - 3 N2 - Cytoprotection or metabolic modulation is a new principle in the treatment of angina pectoris. The effect of ranolazine (a cytoprotective drug) on ischemic threshold, coronary sinus blood flow, and myocardial metabolism was evaluated by means of two pacing sequences in nine male patients with coronary artery disease (CAD) and in eight male controls. Ranolazine was given as an intravenous bolus followed by continuous infusion; the mean total dose was 32.7 mg and 31.7 mg in patients and controls, respectively. Angina pectoris was relieved in two patients after ranolazine but pacing time to pain was unchanged in the remaining patients. Maximal ST depression was lower (p = 0.02), but pacing time to maximal and to 1-mm ST depression remained unchanged after the drug. Ranolazine had no overall influence on coronary sinus blood flow, cardiac oxygen consumption, blood pressure, and heart rate. Cardiac uptake of free fatty acids (FFA) was reduced (p = 0.01), and net uptakes of glucose (p = 0.07) and lactate (p = 0.06) tended to be lower after ranolazine in CAD patients and controls. Ranolazine had no direct influence on cardiac exchange of glutamate, alanine, and citrate or on the arterial concentration of any metabolite. In the present study ranolazine had minimal clinical effects. A decrease in myocardial FFA utilization, however, allows greater myocardial glucose oxidation, which may increase the energy production in relation to oxygen availability. SN - 0920-3206 UR - https://www.unboundmedicine.com/medline/citation/9310277/Effects_of_ranolazine_on_ischemic_threshold_coronary_sinus_blood_flow_and_myocardial_metabolism_in_coronary_artery_disease_ L2 - https://medlineplus.gov/angina.html DB - PRIME DP - Unbound Medicine ER -