Banerjee Kinjal, Ghosh Raktim Kumar, Kamatam Sravani, Banerjee Arnab, Gupta Anjan
Cleveland Clinic, Cleveland, OH, USA.
Department of Internal Medicine, St. Vincent Charity Medical Center, A Teaching Affiliate of Case Western Reserve University, Cleveland, OH, USA.
Int J Cardiol. 2017 Jan 15;227:556-564. doi: 10.1016/j.ijcard.2016.10.102. Epub 2016 Nov 2.
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.
雷诺嗪于2006年获美国食品药品监督管理局（FDA）批准用于治疗慢性心绞痛。自那时以来，针对这种药物开展了广泛的研究。其作用机制在获批时存在争议，但现已得到证实。雷诺嗪通过抑制心肌晚期钠通道电流发挥作用，这一作用是通过降低异常升高的胞浆钙水平来实现的。雷诺嗪的其他潜在临床应用也已得到探索。在众多研究方向中，其在心房颤动（尤其是冠状动脉旁路移植术后和复发性心房颤动）方面的效果显示出前景。在患有冠状动脉疾病的糖尿病患者中使用时，它还显示出明确的糖化血红蛋白（HbA1c）降低作用。该药物的其他潜在适应证包括肺动脉高压、舒张功能障碍和化疗引起的心脏毒性。本综述旨在总结关于雷诺嗪在慢性心绞痛以外潜在应用的主要研究。很少有专门的大型、随机、III期试验探索雷诺嗪的新作用。目前有一些此类试验正在进行，但还需要更多试验。
