Tavazzi Luigi
Institute of Care and Research, Divisione di Cardiologia, IRCCS Policlinico San Matteo, P.le Golgi, 227100 Pavia, Italy.
Future Cardiol. 2005 Jul;1(4):447-55. doi: 10.2217/14796678.1.4.447.
The increasing and unmet social and economic burden of ischemic heart disease calls for new antianginal therapies. Ranolazine, a new antianginal agent, has a different mode of action from existing therapies, which act by decreasing indices of cardiac work. Ranolazine mainly affects the late sodium current across the membrane of cardiomyocytes, inducing a cascade of electrophysiologic and metabolic effects with the potential to reduce the cardiac ischemic burden without significantly changing blood pressure and heart rate. In clinical trials, ranolazine has been demonstrated to exert antianginal and anti-ischemic effects in chronic angina. It improves exercise performance, and decreases angina frequency and nitroglycerin use. Ranolazine is well tolerated at therapeutic doses. Larger studies are needed to explore the effects on hard end-points of morbidity and mortality.
缺血性心脏病不断增加且未得到满足的社会和经济负担促使人们寻求新的抗心绞痛疗法。新型抗心绞痛药物雷诺嗪具有与现有疗法不同的作用模式，现有疗法通过降低心脏作功指标来发挥作用。雷诺嗪主要影响心肌细胞膜上的晚钠电流，引发一系列电生理和代谢效应，有可能减轻心脏缺血负担，而不会显著改变血压和心率。在临床试验中，雷诺嗪已被证明对慢性心绞痛具有抗心绞痛和抗缺血作用。它能改善运动能力，减少心绞痛发作频率和硝酸甘油的使用。雷诺嗪在治疗剂量下耐受性良好。需要开展更大规模的研究来探索其对发病率和死亡率等硬终点的影响。
