Keating Gillian M
Wolters Kluwer Health | Adis, Auckland, New Zealand.
Drugs. 2008;68(17):2483-503. doi: 10.2165/0003495-200868170-00006.
Extended-release ranolazine (ranolazine ER) [Ranexa] is a piperazine derivative with a novel mechanism of action that was recently approved in the EU for use as add-on therapy in patients with stable angina pectoris. Ranolazine ER achieves its antianginal effect without affecting heart rate or blood pressure (BP) to a clinically significant extent. Results of well designed, placebo-controlled, short-term studies demonstrate that add-on therapy with ranolazine ER in patients with chronic stable angina improves exercise performance, and reduces anginal frequency and nitroglycerin use. Although longer-term therapy with ranolazine ER did not reduce the incidence of major cardiovascular events in patients with non-ST-elevation acute coronary syndromes, it did reduce the incidence of recurrent ischaemia. Ranolazine ER is a generally well tolerated antianginal agent. Although it is associated with modest dose-related increases in the corrected QT (QTc) interval, ranolazine ER does not appear to be associated with an excess of arrhythmias. Thus, ranolazine ER is a useful new option for patients with chronic stable angina whose symptoms are not controlled with first-line antianginal therapy or who do not tolerate first-line antianginal agents.
缓释雷诺嗪（雷诺嗪缓释剂）[Ranexa]是一种哌嗪衍生物，具有新颖的作用机制，最近在欧盟被批准用作稳定型心绞痛患者的附加治疗药物。雷诺嗪缓释剂在临床上未对心率或血压产生显著影响的情况下发挥其抗心绞痛作用。精心设计的、安慰剂对照的短期研究结果表明，在慢性稳定型心绞痛患者中，使用雷诺嗪缓释剂进行附加治疗可改善运动能力，减少心绞痛发作频率并减少硝酸甘油的使用。尽管在非ST段抬高型急性冠状动脉综合征患者中，雷诺嗪缓释剂的长期治疗并未降低主要心血管事件的发生率，但它确实降低了复发性缺血的发生率。雷诺嗪缓释剂是一种耐受性普遍良好的抗心绞痛药物。尽管它与校正QT（QTc）间期适度的剂量相关增加有关，但雷诺嗪缓释剂似乎与心律失常的增加无关。因此，对于症状未被一线抗心绞痛治疗控制或不耐受一线抗心绞痛药物的慢性稳定型心绞痛患者，雷诺嗪缓释剂是一种有用的新选择。
