Late sodium channel blockade improves angina and myocardial perfusion in patients with severe coronary microvascular dysfunction: Women's Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction ancillary study

In a prior trial of late sodium channel inhibition (ranolazine) among symptomatic subjects without obstructive coronary artery disease (CAD) and limited myocardial perfusion reserve index (MPRI), we observed no improvement in angina or MPRI, overall. Here we describe the clinical characteristics and...

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Bibliographic Details
Published in:International journal of cardiology 2019-02, Vol.276, p.8-13
Main Authors: Rambarat, Cecil A., Elgendy, Islam Y., Handberg, Eileen M., Bairey Merz, C. Noel, Wei, Janet, Minissian, Margo B., Nelson, Michael D., Thomson, Louise E.J., Berman, Daniel S., Shaw, Leslee J., Cook-Wiens, Galen, Pepine, Carl J.
Format: Article
Language:English
Subjects:
Adult
Aged
Angina
Angina Pectoris - diagnostic imaging
Angina Pectoris - drug therapy
Angina Pectoris - epidemiology
Coronary Angiography - trends
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - drug therapy
Coronary Artery Disease - epidemiology
Coronary Circulation - drug effects
Coronary Circulation - physiology
Coronary microvascular dysfunction
Cross-Over Studies
Double-Blind Method
Female
Humans
Late sodium channel inhibition
Microcirculation - drug effects
Microcirculation - physiology
Middle Aged
Myocardial Ischemia - diagnostic imaging
Myocardial Ischemia - drug therapy
Myocardial Ischemia - epidemiology
Myocardial Perfusion Imaging - trends
Ranolazine - administration & dosage
Severity of Illness Index
Sodium Channel Blockers - administration & dosage
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Summary:In a prior trial of late sodium channel inhibition (ranolazine) among symptomatic subjects without obstructive coronary artery disease (CAD) and limited myocardial perfusion reserve index (MPRI), we observed no improvement in angina or MPRI, overall. Here we describe the clinical characteristics and myocardial perfusion responses of a pre-defined subgroup who had coronary flow reserve (CFR) assessed invasively. Symptomatic patients without obstructive CAD and limited MPRI in a randomized, double-blind, crossover trial of ranolazine vs. placebo were subjects of this prespecified substudy. Because we had previously observed that adverse outcomes and beneficial treatment responses occurred in those with lower CFR, patients were subgrouped by CFR
ISSN:0167-5273
1874-1754
1874-1754
DOI:10.1016/j.ijcard.2018.09.081