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Use of Ranolazine for the Treatment of Coronary Microvascular Dysfunction
American Journal of Cardiovascular Drugs ( IF 3 ) Pub Date : 2021-01-13 , DOI: 10.1007/s40256-020-00462-6
Randall P Sharp 1 , Edna Patatanian 2 , Riaz Sirajuddin 3
Affiliation  

Coronary microvascular dysfunction (CMD) is defined as a mismatch of myocardial blood supply and oxygen consumption due to a dysfunction of the coronary microvessels. Up to 20–30% of patients with CMD have progressive worsening of symptoms with significant impairment of quality of life. Large-scale randomized studies of the pharmacologic treatment of CMD are lacking. Classic anti-ischemic drugs are the initial form of treatment, but efficacy is often limited. Ranolazine has a unique mechanism of action that does not affect blood pressure or heart rate. When added to existing anti-anginal agents, ranolazine improved at least one domain in eight of ten studies in which a questionnaire was used to assess patient health status. Five studies evaluated coronary arterial flow reserve (CFR), reporting that patients with low values had significant improvement in CFR and suggesting that those with more severe CMD respond more favorably to ranolazine. In two studies, exercise duration and time to myocardial ischemia were significantly increased after treatment with ranolazine. Data are lacking for ranolazine use as the sole agent for CMD treatment. Some questions remain to be answered regarding ranolazine use for CMD. Larger studies of longer duration are needed to verify the effectiveness of ranolazine in the treatment of CMD.



中文翻译:

雷诺嗪在治疗冠状动脉微血管功能障碍中的用途

冠状动脉微血管功能障碍(CMD)被定义为由于冠状动脉微血管功能障碍导致心肌供血和耗氧量不匹配。高达 20-30% 的 CMD 患者症状进行性恶化,生活质量显着受损。缺乏对 CMD 药物治疗的大规模随机研究。经典的抗缺血药物是最初的治疗形式,但疗效往往有限。雷诺嗪具有独特的作用机制,不会影响血压或心率。当将雷诺嗪添加到现有的抗心绞痛药物中时,在使用问卷评估患者健康状况的十项研究中的八项中,雷诺嗪至少改善了一个领域。五项研究评估了冠状动脉血流储备 (CFR),报告低值患者的 CFR 有显着改善,并表明那些患有更严重 CMD 的患者对雷诺嗪的反应更有利。在两项研究中,雷诺嗪治疗后运动持续时间和心肌缺血时间显着增加。缺乏雷诺嗪作为 CMD 治疗唯一药物的数据。关于雷诺嗪用于 CMD 的一些问题仍有待回答。需要更长时间的更大规模研究来验证雷诺嗪治疗 CMD 的有效性。关于雷诺嗪用于 CMD 的一些问题仍有待回答。需要更长时间的更大规模研究来验证雷诺嗪治疗 CMD 的有效性。关于雷诺嗪用于 CMD 的一些问题仍有待回答。需要更长时间的更大规模研究来验证雷诺嗪治疗 CMD 的有效性。

更新日期:2021-01-13
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