Ranolazine improves endothelial function in patients with stable coronary artery disease

Smriti H. Deshmukh, Snehal R. Patel, Elsa Pinassi, Catalin Mindrescu, Eileen V. Hermance, Michael N. Infantino, John T. Coppola, Cezar S. Staniloae

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Objectives: We investigated the effect of ranolazine on endothelial-dependent vasodilatation (EDV), serum markers of endothelial dysfunction, and inflammation. Background: Endothelial dysfunction has been shown to be independently associated with the occurrence of cardiovascular events. We sought to investigate whether ranolazine, a novel antianginal medication with no effect on heart rate or blood pressure, improves endothelial function in patients with stable coronary artery disease (CAD). Methods: Twenty-seven patients with stable CAD were randomly assigned to either 1000mg twice daily of ranolazine or to matching placebo for 6 weeks and then crossed over for an additional 6 weeks in a double-blind design. EDV was assessed using reactive hyperemia peripheral arterial tonometry (RH-PAT) at baseline, 6, and 12 weeks. Markers of endothelial dysfunction and inflammation were also evaluated. Results: After 6 weeks, treatment with ranolazine significantly increased the EDV RH-PAT index as compared with baseline (1.85± 0.42 vs. 2.08± 0.57, P = 0.037). EDV RH-PAT did not change while on placebo (1.69± 0.35 vs. 1.78±0.41, P =0.29). In addition, there was a significant drop in asymmetric dimethylarginine levels with ranolazine treatment (0.66± 0.12 vs. 0.60 ±0.11 lmol/l, P = 0.02) and a near significant decrease in C-reactive protein levels (0.40 ±0.80 vs. 0.30± 0.61 mg/dl, P = 0.05). Conclusion: Ranolazine improves endothelial function, asymmetric dimethylarginine, and C-reactive protein levels in a group of patients with stable CAD. Our results suggest a novel mechanism of action of ranolazine.

Original languageEnglish (US)
Pages (from-to)343-347
Number of pages5
JournalCoronary Artery Disease
Volume20
Issue number5
DOIs
StatePublished - Aug 1 2009
Externally publishedYes

Keywords

  • Coronary artery disease
  • Endothelial function
  • Peripheral artery tonometry
  • Ranolazine

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Deshmukh, S. H., Patel, S. R., Pinassi, E., Mindrescu, C., Hermance, E. V., Infantino, M. N., Coppola, J. T., & Staniloae, C. S. (2009). Ranolazine improves endothelial function in patients with stable coronary artery disease. Coronary Artery Disease, 20(5), 343-347. https://doi.org/10.1097/MCA.0b013e32832a198b