scholarly journals Safety and Efficacy of Ranolazine for the Treatment of Chronic Angina Pectoris

2013 ◽  
Vol 5 ◽  
pp. CMT.S7824 ◽  
Author(s):  
Mohammed Aldakkak ◽  
David F. Stowe ◽  
Amadou K.S. Camara
Keyword(s):  
Coronary Heart Disease ◽  
Blood Flow ◽  
Heart Disease ◽  
Supply And Demand ◽  
Chronic Stable Angina ◽  
The United States ◽  
Lifestyle Changes ◽  
Channel Blockers ◽  
Coronary Syndrome ◽  
Chronic Angina

Coronary heart disease is a global malady and it is the leading cause of death in the United States. Chronic stable angina is the most common manifestation of coronary heart disease and it results from the imbalance between myocardial oxygen supply and demand due to reduction in coronary blood flow. Therefore, in addition to lifestyle changes, commonly used pharmaceutical treatments for angina (nitrates, β-blockers, Ca2+ channel blockers) are aimed at increasing blood flow or decreasing O2 demand. However, patients may continue to experience symptoms of angina. Ranolazine is a relatively new drug with anti-anginal and anti-arrhythmic effects. Its anti-anginal mechanism is not clearly understood but the general consensus is that ranolazine brings about its anti-anginal effects by inhibiting the late Na+ current and the subsequent intracellular Ca2+ accumulation. Recent studies suggest other effects of ranolazine that may explain its anti-anginal and anti-arrhythmic effects. Nonetheless, clinical trials have proven the efficacy of ranolazine in treating chronic angina. It has been shown to be ineffective, however, in treating acute coronary syndrome patients. Ranolazine is a safe drug with minimal side effects. It is metabolized mainly in the liver and cleared by the kidney. Therefore, caution must be taken in patients with impaired hepatic or renal function. Due to its efficacy and safety, ranolazine was approved for the treatment of chronic angina by the Food and Drug Administration (FDA) in 2006.

scholarly journals Coronary Heart Disease: Diagnosis and Therapy

2021 ◽  
Vol 1 (2) ◽  
pp. 74
Author(s):  
Iin Novita Nurhudayati Mahmuda ◽  
Nanda Nurkusumasari ◽  
Fakhri Nofaldi ◽  
Prihatin Puji Astuti ◽  
Ferika Dian Syafitri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Communicable Disease ◽  
Developed Countries ◽  
Disease Diagnosis ◽  
Lifestyle Changes ◽  
World Health ◽  
Coronary Syndrome ◽  
Health Organization

<p>Coronary heart disease (CHD), is one of the non-communicable diseases that has a tendency to increase every year and have an impact not only on developed countries, but also in developing countries. According to the World Health Organization (WHO), in 2012 there were 56 million deaths worldwide caused by non-communicable disease and heart disease contributed 46.2% or caused 17.5 million deaths. This review article to give brief explanation about CHD from risk factors, diagnosed criteria, management therapy and prognosis. Risk factors for CHD can be distinguished into major risk factors and minor risk factors. Symptoms of CHD are discomfort in the chest ranging from pain crushed during activity and improved with rest to continuous chest pain. The diagnosis of CHD is established based on anamnesis, physical examination, and laboratory examination. The CHD classification consists  of Stable Angina Pectoris (APS) and Acute Coronary Syndrome (ACS). Lifestyle changes accompanied<em> </em>by right medication can reduce complications caused             by CHD.</p>

Antianginal Therapy for Stable Ischemic Heart Disease

2017 ◽  
Vol 22 (6) ◽  
pp. 499-510 ◽  
Author(s):  
Santosh K. Padala ◽  
Michael P. Lavelle ◽  
Mandeep S. Sidhu ◽  
Katherine P. Cabral ◽  
Doralisa Morrone ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
The United States ◽  
Lifestyle Changes ◽  
Ischemic Heart ◽  
Microvascular Angina ◽  
Pharmacologic Intervention ◽  
Stable Ischemic Heart Disease ◽  
Chronic Angina ◽  
Β Blockers

Chronic angina pectoris is associated with considerable morbidity and mortality, especially if treated suboptimally. For many patients, aggressive pharmacologic intervention is necessary in order to alleviate anginal symptoms. The optimal treatment of stable ischemic heart disease (SIHD) should be the prevention of angina and ischemia, with the goal of maximizing both quality and quantity of life. In addition to effective risk factor modification with lifestyle changes, intensive pharmacologic secondary prevention is the therapeutic cornerstone in managing patients with SIHD. Current guidelines recommend a multifaceted therapeutic approach with β-blockers as first-line treatment. Another important pharmacologic intervention for managing SIHD is nitrates. Nitrates can provide both relief of acute angina and can be used prophylactically before exposure to known triggers of myocardial ischemia to prevent angina. Additional therapeutic options include calcium channel blockers and ranolazine, an inhibitor of the late inward sodium current, that can be used alone or in addition to nitrates or β-blockers when these agents fail to alleviate symptoms. Ranolazine appears to be particularly effective for patients with microvascular angina and endothelial dysfunction. In addition, certain antianginal therapies are approved in Europe and have been shown to improve symptoms, including ivabradine, nicorandil, and trimetazidine; however, these have yet to be approved in the United States. Ultimately, there are several different medications available to the physician for managing the patient with SIHD having chronic angina, when either used alone or in combination. The purpose of this review is to highlight the most important therapeutic approaches to optimizing contemporary treatment in response to individual patient needs.

Resistance to change: Role of relationship and communal coping for coronary heart disease patients and their partners in making lifestyle changes

2018 ◽  
Vol 46 (6) ◽  
pp. 659-666 ◽  
Author(s):  
Nina Konstantin Nissen ◽  
Mjöll Jónsdóttir ◽  
Helle Spindler ◽  
Ann-Dorthe Olsen Zwisler
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Resistance To Change ◽  
Lifestyle Changes ◽  
Dyadic Interaction ◽  
Communal Coping ◽  
Coronary Syndrome ◽  
Key Factor ◽  
Prevention Programmes

Background: Lifestyle behaviours are important risk factors for coronary heart disease (CHD) and, hence, motivation for lifestyle changes is suggested to be a key factor in the success of cardiac rehabilitation and secondary prevention programmes. The motivation for changing lifestyle among people with CHD may be influenced by those with whom they have long-term, intimate relationships. Aims: This study explores the role of the relationship between people with CHD and those closest to them in making lifestyle changes. This includes investigating if patients and partners experience autonomy, competence, and relatedness, and what role communal, i.e. relationship-centred coping serves in relation to patients’ health behaviour. Methods: The study is based on semi-structured, in-depth interviews with 10 couples; people who have experienced acute coronary syndrome, and their partners. Participants had diverse histories of disease and social backgrounds. A three-stage interview process was undertaken including focus group interviews, couple interviews and individual interviews. A thematic analysis, inspired by the self-determination theory and the interdependence theory, was conducted. Results: Communal coping is evident in various forms, and at different levels, among people with CHD and their partners. Satisfaction with new lifestyle, ownership of change, confidence in ability to change, and emotional distress are all factors that affect how couples deal with lifestyle changes in the aftermath of CHD. Conclusions: Rehabilitation efforts, aimed at lifestyle changes, need to address each individual, as well as the dyadic interaction within couples. Incorporating a dyadic perspective in the rehabilitation process may lead to a reduction in motivational barriers to lifestyle changes.

Long-Term Continuation on Cardiovascular Drug Treatment in Patients with Coronary Heart Disease

2007 ◽  
Vol 41 (10) ◽  
pp. 1644-1647 ◽  
Author(s):  
David S Wald ◽  
Geraint Morton ◽  
Kate Walker ◽  
Neil Losson ◽  
Nick P Curzen
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Drug Therapy ◽  
Coronary Intervention ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Cardiovascular Drug ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Coronary Syndrome

Background: Combination therapy to reduce risk factors is effective in preventing recurrent cardiovascular disease events in patients with coronary heart disease (CHD), but medications need to be continued indefinitely to maximize the benefits. Objective: To evaluate the extent of long-term continuation with cardiovascular drug therapy and its expected impact on the prevention of CHD. Methods: We studied 242 patients with CHD who underwent percutaneous coronary intervention following an acute coronary syndrome over a 6 month period in 2004. We prospectively examined the extent to which specific drugs and drug combinations were continued over lime by reviewing medication use at the time of hospital discharge and after 2 years. The results were used to estimate the expected loss in preventive efficacy due to discontinuation of therapy. Results: The changes over a 2 year period in the proportions of patients taking each drug class were as follows: 15% reduction for aspirin (95% Cl, -21 to -9), 10% reduction for statins (95% Cl, -16 to 5), 19% reduction for angiotensin-converting enzyme inhibitors (95% Cl, -26 to -12), 12% reduction for β-blockers (95% Cl, -18 to -6), 0% increase for calcium-channel blockers (95% Cl, -5 to 6), 2% increase for thiazides (95% Cl, -2 to 6), and 12% increase for angiotensin-11 receptor blockers (95% Cl, 6 to 18). The combination of aspirin, statin, and at least 2 blood pressure lowering drugs was prescribed to 81% of patients, three-quarters of whom remained on this combination after 2 years. The overall expected preventive effect on CHD of the combined medication taken during hospitalization and after 2 years was 80% and 74%, respectively. Conclusions: In patients with CHD, long-term continuation of combination cardiovascular drug therapy is considerably greater than generally perceived.

scholarly journals Prognostic Biomarkers in Individuals with Prevalent Coronary Heart Disease

2009 ◽  
Vol 26 (5-6) ◽  
pp. 265-271 ◽  
Author(s):  
Sharif A. Halim ◽  
L. Kristin Newby
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Risk Stratification ◽  
Coronary Disease ◽  
The United States ◽  
Global Scale ◽  
World Health ◽  
Cardiac Events ◽  
Ischemic Event ◽  
Coronary Syndrome

Coronary disease is the leading killer of individuals worldwide and a leading cause of healthcare expenditure. On a global scale, ischemic heart disease kills over 6 million individuals each year and is projected by the World Health Organization to be the greatest single-disease cause of death worldwide by an increasing margin into 2030. Nearly 17 million Americans (7.6% of the population) have prevalent coronary heart disease, 8 million of whom have had a prior myocardial infarction. It is estimated that in 2009, 550,000 will die from coronary heart disease in the United States and that the direct and indirect costs from treating coronary heart disease will exceed $165 billion. Although patients with known coronary artery disease are among the highest risk patients for future cardiac events, not all patients with coronary disease will have an ischemic event (first or recurrent). Determining which of these patients will have an ischemic event is critical to the concept of personalized cardiovascular care. Increasingly, biomarkers that can be readily assayed from blood or other body fluids will be critical to risk stratification and effective application of secondary prevention strategies, just as they have played an increasingly prominent role in risk stratification of acute coronary syndrome patients.

Integration Between Computed Tomography and Nuclear Medicine for Non-invasive Assessment of Coronary Anatomy and Myocardial Perfusion

2009 ◽  
Vol 5 (2) ◽  
pp. 15
Author(s):  
Wanda Acampa ◽  
Mario Petretta ◽  
Carmela Nappi ◽  
Alberto Cuocolo ◽  
◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Heart Disease ◽  
Blood Flow ◽  
Heart Disease ◽  
Myocardial Perfusion ◽  
Myocardial Blood Flow ◽  
Imaging Techniques ◽  
Emission Computed Tomography ◽  
Coronary Anatomy ◽  
Non Invasive

Many non-invasive imaging techniques are available for the evaluation of patients with known or suspected coronary heart disease. Among these, computed-tomography-based techniques allow the quantification of coronary atherosclerotic calcium and non-invasive imaging of coronary arteries, whereas nuclear cardiology is the most widely used non-invasive approach for the assessment of myocardial perfusion. The available single-photon-emission computed tomography flow agents are characterised by a cardiac uptake proportional to myocardial blood flow. In addition, different positron emission tomography tracers may be used for the quantitative measurement of myocardial blood flow and coronary flow reserve. Extensive research is being performed in the development of non-invasive coronary angiography and myocardial perfusion imaging using cardiac magnetic resonance. Finally, new multimodality imaging systems have recently been developed bringing together anatomical and functional information. This article provides a description of the available non-invasive imaging techniques in the assessment of coronary anatomy and myocardial perfusion in patients with known or suspected coronary heart disease.

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