Trimetazidine, Ranolazine, Ivabradine Antagonize Stable Coronary Artery Disease Otherwise from Conventional Anti-Ischemic Drugs

Federico Cacciapuoti


Stable coronary artery disease (SCAD), is caused by an imbalance between myocardial blood supply and oxygen demand. It occurs when the heart muscle doesn’t get as much blood as it needs. Specifically, it isn’t acute coronary angina, but suggests that a heart attack is more likely to happen in the future. Sometimes, conventional anti-ischemic drugs can be insufficient to improve the symptoms in the presence of SCAD. But, their association with some agents having different mechanisms from traditional anti-ischemic compounds, such as Trimetazidine, Ranolazine or Ivabradine (second line of treatment) may be effective. These (especially when given in association with nitrates, beta-blockers or calcium-antagonists) obtained significant results in numerous SCAD-studies when conventional drugs alone were ineffective. In addition, Ranolazine shown interesting anti-arrhythmic effects both in supra-and-ventricular arrhythmias and, given alone or in association with other anti-arrhythmics (as Cordarone or Dronedarone) obtained promising results in these rhythm disturbances.


Stable coronary artery disease (SCAD); Conventional anti-ischemic drugs; Trimetazidine; Ranolazine; Ivabradine

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