Chronic angina represents a condition that impairs quality of life and is associated with
decreased life expectancy in the industrialized countries. Current therapies that reduce angina
frequency include old drugs such as nitrates, β -blockers and calcium antagonists. Several new
investigational drugs are being tested for the treatment of chronic angina. This review will focus on
ranolazine, a drug approved by the US Food and Drug Administration (FDA) in 2006 for patients
with chronic angina who continue to be symptomatic despite optimized therapies. The main
molecular mechanism underlying ranolazine-mediated beneficial effects has been identified as
inhibition of the late Na+ current during the action potential, which potentially improves oxygen consumption, diastolic
dysfunction and coronary blood flow. The aim of this review is to update the evidence for ranolazine treatment in chronic
angina and discuss its therapeutic perspectives based on the most recent clinical and experimental studies.
Keywords: Calcium antagonist, coronary artery disease, ranolazine, stable angina, β-blockers, nitrogen.
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