Possibilities of using a drug with a multifactorial mechanism of action in the treatment of patients with ischemic heart disease with rhythm disturbances and diabetes mellitus | Ukrainian Medical Journal

Iablonska V.B.,Kholopov L.S.,Khyzhnyak O.V.,Batashova-Halinska V.O.

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Possibilities of using a drug with a multifactorial mechanism of action in the treatment of patients with ischemic heart disease with rhythm disturbances and diabetes mellitus

Possibilities of using a drug with a multifactorial mechanism of action in the treatment of patients with ischemic heart disease with rhythm disturbances and diabetes mellitus

May 6, 2025

156

Cardiology, Rheumatology

Batashova-Halinska V.O.

УДК: 616.12-005.4-06:[616.12-008.318+616.379-008.64]-08:615.038

DOI: 10.32471/umj.1680-3051.265357

Keywords :

arrhythmia,

diabetes mellitus,

ischemic disease

Specialities :

Cardiology, Rheumatology

Endocrinology

Resume

Objective: to establish the effectiveness of treatment of patients with severe angina pectoris in combination with diabetes mellitus (DM) of moderate severity, using the selective inhibitor of late sodium current ranolazine.

Object and methods of the study. An open prospective study of 29 patients with ischemic heart disease (CHD), stable angina of stress of functional class (FC) III–IV in combination with DM of moderate severity was conducted. Patients were prescribed ranolazine in addition to the main therapy. The effectiveness of the therapy was assessed after 3 and 6 months of treatment.

Results. 72.4% of patients suffered from angina pectoris of FC III, 27.6% from FC IV. At the end of the 3rd month, angina attacks were not observed in all patients with angina pectoris of FC III and in 62.5% of patients with angina pectoris of FC IV. The same results were obtained when surveying patients at the end of 6 months of observation. At the end of 3 months of observation, none of the patients noted arrhythmias. 3 months after the start of observation, fasting blood glucose levels decreased in 86.2% of patients, HbA1c levels decreased in 82.8% of patients, and after 6 months, these indicators decreased in all patients.

Conclusion. Ranolazine can be recommended for patients with stable angina with arrhythmias. The use of ranolazine may be effective in patients with CHD in combination with type 2 DM. The use of ranolazine significantly affects the quality of life and helps improve patient adherence to treatment.

References

1. Marx N., Federici M., Schütt K. et al. (2023) ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur. Heart J., 44(39): 4043–4140. doi: 10.1093/eurheartj/ehad192.
2. Cattaneo M., Halasz G., Cattaneo M.M. et al. (2022) The Central Nervous System and Psychosocial Factors in Primary Microvascular Angina. Front. Cardiovasc. Med., 9: 896042. doi.org/10.3389/fcvm.2022.896042.
3. Ismaiel A., Spinu M., Leucuta D.C. et al. (2022) Anxiety and Depression in Metabolic-Dysfunction-Associated Fatty Liver Disease and Cardiovascular Risk. J. Clin. Med., 11(9): 2488. doi.org/10.3390/jcm11092488.
4. Kofler T., Hess S., Moccetti F. et al. (2020) Efficacy of Ranolazine for Treatment of Coronary Microvascular Dysfunction-A Systematic Review and Meta-analysis of Randomized Trials. Can. J. Cardiol., 3(1): 101–108. doi.org/10.1016/j.cjco.2020.09.005.
5. Maulana S., Nuraeni A., Aditya Nugraha B. (2022) The Potential of Prognostic Biomarkers of Uric Acid Levels in Coronary Heart Disease Among Aged Population: A Scoping Systematic Review of the Latest Cohort Evidence. J. Multidisciplinary Healthcare, 15: 161–173. doi.org/10.2147/JMDH.S340596.
6. Reed M., Kerndt C.C., Gopal S. et al. (2025) Ranolazine. In: StatPearls. Treasure Island: StatPearls Publ. http://www.ncbi.nlm.nih.gov/books/NBK507828/.
7. Sharp R.P., Patatanian E., Sirajuddin R. (2021) Use of ranolazine for the treatment of coronary microvascular dysfunction. Am. J. Cardiovasc. Drugs, 21: 513–521. doi: 10.1007/s40256-020-00462-6.
8. Яблонська В.Б., Холопов Л.С., Хижняк О.В., Баташова-Галинська В.О. (2023) Нові перспективи в лікуванні ішемічної хвороби серця у пацієнтів із порушеннями ритму серця й артеріальною гіпертензією. Укр. мед. часопис, 2(154): 98–101. doi.org/10.32471/umj.1680-3051.154.241348.
9. Kaplan A., Amin G., Abidi E. et al. (2022) Role of ranolazine in heart failure: From cellular to clinic perspective. Eur. J. Pharmacol., 919: 174787. doi: 10.1016/j.ejphar.2022.174787.
10. Leelapatana P., Thongprayoon C., Prasitlumkum N. et al. (2021) Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical Trials. Diseases, 9(2): 31. doi: 10.3390/diseases9020031.
11. Cattaneo M., Porretta A.P., Gallino A. (2015) Ranolazine: Drug overview and possible role in primary microvascular angina management. Int. J. Cardiol., 181: 376–381. doi: 10.1016/j.ijcard.2014.12.055.
12. Cempaka Putri D.K.S., Andrianto A., Al-Farabi M.J. et al. (2023) Efficacy of Ranolazine to Improve Diastolic Performance in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-analysis. Eur. Cardiol., 18: e02. doi: 10.15420/ecr.2022.10.
13. Ghosh G.C., Ghosh R.K., Bandyopadhyay D. et al. (2018) Ranolazine: Multifaceted Role beyond Coronary Artery Disease, a Recent Perspective. Heart Views, 19(3): 88–98. doi.org/10.4103/heartviews.heartviews_18_18.
14. Manolis A., Kallistratos M., Poulimenos L. et al. (2023) Effects of ranolazine on various outcomes in patients with stable angina: an updated meta-analysis. Hellenic J. Cardiol., 71: 26–32. doi: 10.1016/j.hjc.2022.12.002.
15. Eckel R.H., Henry R.R., Yue P. et al. (2015) Effect of Ranolazine Monotherapy on Glycemic control in Subjects With Type 2 Diabetes. Diabetes Care, 38: 1189–1196. DOI: 10.2337/dc14-2629.
16. Arnold S.V., Bhatt D.L., Barsness G.W. et al. (2020) Clinical Management of Stable Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus. Circulation, 141: e779–e806. DOI: 10.1161/CIR.0000000000000766.
17. Knuuti J., Wijns W., Saraste A. et al. (2019) ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology. Eur. Heart J., 41 (3): 407–477. doi.org/10.1093/eurheartj/ehz425.
18. Rosano G., Vitale C. (2018) Metabolic Modulation of Cardiac Metabolism in Heart Failure. Cardiac Failure Rev., 4(2): 99–103. doi.org/10.15420/cfr.2018.18.2.
19. Volynskyi D., Vakaliuk I. (2019) Use Of Meldonium In The Treatment Of Patients With Coronary Artery Disease And Concomitant Arterial Hypertension. Eureka: Health Sciences, 6(6): 9–14. doi.org/10.21303/2504-5679.2019.001018.
20. Zweiker R., Aichinger J., Metzler B. et al. (2019) Ranolazine: impact on quality of life in patients with stable angina pectoris, results from an observational study in Austria — the ARETHA AT study. Wien Klin Wochenschr., 131(7–8): 165–173. doi: 10.1007/s00508-019-1481-x.
21. Andrievskaya S., Krotenko V., Kolesnik V. (2019) New components of contemporary arrhythmology — the basics of pathogenesis and their clinical justification. Med. Ukraine, 16–23. doi: 10.37987/1997-9894.2019.8(234).187158.