Effect of Ranolazine on Ischemic Myocardium IN Patients With Acute Cardiac Ischemia (RIMINI-Trial): A Randomized Controlled Pilot Trial.


Journal

Journal of cardiovascular pharmacology and therapeutics
ISSN: 1940-4034
Titre abrégé: J Cardiovasc Pharmacol Ther
Pays: United States
ID NLM: 9602617

Informations de publication

Date de publication:
01 2019
Historique:
pubmed: 26 6 2018
medline: 1 1 2020
entrez: 26 6 2018
Statut: ppublish

Résumé

Coronary artery disease is the most prevalent manifestation among cardiovascular diseases. Despite modern treatment, risk of ischemic complications in patients with acute coronary syndrome (ACS) remains important. The late Na The trial was designed in a 2-armed, controlled and randomized way. Twenty participants with unstable angina, proof of acute cardiac ischemia, and myocardial dyskinesia by speckle-tracking echocardiography were included. Ten participants received the study drug ranolazine additionally to standard treatment. The control group received standard treatment without additional study medication. Speckle-tracking echocardiography was performed before coronary intervention, before the first dose of ranolazine, and after 6 weeks of ranolazine treatment. Ranolazine was administered safely during acute myocardial infarction. Speckle-tracking echocardiography proved to be suitable for evaluation of myocardial dyskinesia. Patients receiving ranolazine showed a trend to higher normal fraction of the cumulative global strain than patients in the standard treatment group (15% vs 11%). No major complications relating study medication were observed. In conclusion, in this preliminary hypothesis-driven study, 6-week ranolazine therapy was shown to decrease the area of dyskinetic myocardium in patients with ACS by trend. Global strain rate measurement using speckle-tracking echocardiography can be applied measuring those effects and is, compared to other techniques, safe and harmless. Our data provide a sound basis for a follow-up trial.

Sections du résumé

BACKGROUND
Coronary artery disease is the most prevalent manifestation among cardiovascular diseases. Despite modern treatment, risk of ischemic complications in patients with acute coronary syndrome (ACS) remains important. The late Na
METHODS AND RESULTS
The trial was designed in a 2-armed, controlled and randomized way. Twenty participants with unstable angina, proof of acute cardiac ischemia, and myocardial dyskinesia by speckle-tracking echocardiography were included. Ten participants received the study drug ranolazine additionally to standard treatment. The control group received standard treatment without additional study medication. Speckle-tracking echocardiography was performed before coronary intervention, before the first dose of ranolazine, and after 6 weeks of ranolazine treatment. Ranolazine was administered safely during acute myocardial infarction. Speckle-tracking echocardiography proved to be suitable for evaluation of myocardial dyskinesia. Patients receiving ranolazine showed a trend to higher normal fraction of the cumulative global strain than patients in the standard treatment group (15% vs 11%). No major complications relating study medication were observed.
CONCLUSION
In conclusion, in this preliminary hypothesis-driven study, 6-week ranolazine therapy was shown to decrease the area of dyskinetic myocardium in patients with ACS by trend. Global strain rate measurement using speckle-tracking echocardiography can be applied measuring those effects and is, compared to other techniques, safe and harmless. Our data provide a sound basis for a follow-up trial.

Identifiants

pubmed: 29938533
doi: 10.1177/1074248418784290
doi:

Substances chimiques

Sodium Channel Blockers 0
Ranolazine A6IEZ5M406

Banques de données

ClinicalTrials.gov
['NCT01797484']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

62-69

Auteurs

Tjark F Schwemer (TF)

1 Department for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.

Lukas Radziwolek (L)

1 Department for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.

Navina Deutscher (N)

1 Department for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.

Nadine Diermann (N)

1 Department for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.

Susanne Sehner (S)

2 Department of Medical Biometry and Epidemiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.

Stefan Blankenberg (S)

1 Department for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
3 Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
4 DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Germany.

Felix W Friedrich (FW)

3 Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
4 DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Germany.
5 Institute of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

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Classifications MeSH