Ranolazine improves insulin resistance in non-diabetic patients with coronary heart disease. A pilot study

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Abstract

Background The aim of this pilot study was to evaluate if ranolazine (R) could improve insulin resistance (IR) in obese/overweight non-diabetic patients with coronary heart disease (CHD). Methods The study enrolled 40 patients with already diagnosed CHD, previous revascularization, residual ischemia at ergometric test and IR. Mean age was 62.4 ± 9 years, M/F = 31/9. Patients were randomly assigned to one of the two following groups: group 1 (20 patients) started R at dose of 500 mg/bid; group 2 (20 patients) increased the dose of beta/blockers or calcium-channel blockers without introducing R. IR was defined as having HOMA-IR > 2.5. At baseline and after 12 weeks, all subjects performed an ergometric test and 12 h fasting blood sample collection for determining glucose and insulin levels. Results At 12 weeks follow-up visit HOMA-IR significantly decreased in group 1 (from 3.1 ± 1.7 to 2.3 ± 0.9; p = 0.02) while it remained unchanged in group 2 (from 3.0 ± 1.4 to 2.8 ± 1.2; p = 0.14) (between groups p = 0.009). At 12 weeks follow-up visit patients of both groups obtained a significant increase of ischemic threshold at ergometric test, compared to baseline, (group 1 from 308.4 ± 45 s to 423.9 ± 57 s, p = 0.0004); (group 1 from 315.7 ± 63 s to 441.2 ± 51 s, p = 0.0001); without between groups difference (p = 0.25). Conclusions Our data suggest that starting R, instead of increasing the dose of beta-blockers/calcium-channel blockers, could be a preferable choice in obese/overweight CHD subjects with residual ischemia after revascularization.

Original languageEnglish
Pages (from-to)127-129
Number of pages3
JournalInternational Journal of Cardiology
Volume219
DOIs
Publication statusPublished - Sep 15 2016

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Coronary Disease
Insulin Resistance
Calcium Channel Blockers
Ischemia
Ranolazine
Fasting
Insulin
Glucose

Keywords

  • Coronary heart disease
  • Insulin resistance
  • Ranolazine

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{0018eccf57ce4c4fb17ad5179483782a,
title = "Ranolazine improves insulin resistance in non-diabetic patients with coronary heart disease. A pilot study",
abstract = "Background The aim of this pilot study was to evaluate if ranolazine (R) could improve insulin resistance (IR) in obese/overweight non-diabetic patients with coronary heart disease (CHD). Methods The study enrolled 40 patients with already diagnosed CHD, previous revascularization, residual ischemia at ergometric test and IR. Mean age was 62.4 ± 9 years, M/F = 31/9. Patients were randomly assigned to one of the two following groups: group 1 (20 patients) started R at dose of 500 mg/bid; group 2 (20 patients) increased the dose of beta/blockers or calcium-channel blockers without introducing R. IR was defined as having HOMA-IR > 2.5. At baseline and after 12 weeks, all subjects performed an ergometric test and 12 h fasting blood sample collection for determining glucose and insulin levels. Results At 12 weeks follow-up visit HOMA-IR significantly decreased in group 1 (from 3.1 ± 1.7 to 2.3 ± 0.9; p = 0.02) while it remained unchanged in group 2 (from 3.0 ± 1.4 to 2.8 ± 1.2; p = 0.14) (between groups p = 0.009). At 12 weeks follow-up visit patients of both groups obtained a significant increase of ischemic threshold at ergometric test, compared to baseline, (group 1 from 308.4 ± 45 s to 423.9 ± 57 s, p = 0.0004); (group 1 from 315.7 ± 63 s to 441.2 ± 51 s, p = 0.0001); without between groups difference (p = 0.25). Conclusions Our data suggest that starting R, instead of increasing the dose of beta-blockers/calcium-channel blockers, could be a preferable choice in obese/overweight CHD subjects with residual ischemia after revascularization.",
keywords = "Coronary heart disease, Insulin resistance, Ranolazine",
author = "Giuseppe Caminiti and Chiara Fossati and Daniela Battaglia and Rosalba Massaro and Giuseppe Rosano and Maurizio Volterrani",
year = "2016",
month = "9",
day = "15",
doi = "10.1016/j.ijcard.2016.06.003",
language = "English",
volume = "219",
pages = "127--129",
journal = "International Journal of Cardiology",
issn = "0167-5273",
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T1 - Ranolazine improves insulin resistance in non-diabetic patients with coronary heart disease. A pilot study

AU - Caminiti, Giuseppe

AU - Fossati, Chiara

AU - Battaglia, Daniela

AU - Massaro, Rosalba

AU - Rosano, Giuseppe

AU - Volterrani, Maurizio

PY - 2016/9/15

Y1 - 2016/9/15

N2 - Background The aim of this pilot study was to evaluate if ranolazine (R) could improve insulin resistance (IR) in obese/overweight non-diabetic patients with coronary heart disease (CHD). Methods The study enrolled 40 patients with already diagnosed CHD, previous revascularization, residual ischemia at ergometric test and IR. Mean age was 62.4 ± 9 years, M/F = 31/9. Patients were randomly assigned to one of the two following groups: group 1 (20 patients) started R at dose of 500 mg/bid; group 2 (20 patients) increased the dose of beta/blockers or calcium-channel blockers without introducing R. IR was defined as having HOMA-IR > 2.5. At baseline and after 12 weeks, all subjects performed an ergometric test and 12 h fasting blood sample collection for determining glucose and insulin levels. Results At 12 weeks follow-up visit HOMA-IR significantly decreased in group 1 (from 3.1 ± 1.7 to 2.3 ± 0.9; p = 0.02) while it remained unchanged in group 2 (from 3.0 ± 1.4 to 2.8 ± 1.2; p = 0.14) (between groups p = 0.009). At 12 weeks follow-up visit patients of both groups obtained a significant increase of ischemic threshold at ergometric test, compared to baseline, (group 1 from 308.4 ± 45 s to 423.9 ± 57 s, p = 0.0004); (group 1 from 315.7 ± 63 s to 441.2 ± 51 s, p = 0.0001); without between groups difference (p = 0.25). Conclusions Our data suggest that starting R, instead of increasing the dose of beta-blockers/calcium-channel blockers, could be a preferable choice in obese/overweight CHD subjects with residual ischemia after revascularization.

AB - Background The aim of this pilot study was to evaluate if ranolazine (R) could improve insulin resistance (IR) in obese/overweight non-diabetic patients with coronary heart disease (CHD). Methods The study enrolled 40 patients with already diagnosed CHD, previous revascularization, residual ischemia at ergometric test and IR. Mean age was 62.4 ± 9 years, M/F = 31/9. Patients were randomly assigned to one of the two following groups: group 1 (20 patients) started R at dose of 500 mg/bid; group 2 (20 patients) increased the dose of beta/blockers or calcium-channel blockers without introducing R. IR was defined as having HOMA-IR > 2.5. At baseline and after 12 weeks, all subjects performed an ergometric test and 12 h fasting blood sample collection for determining glucose and insulin levels. Results At 12 weeks follow-up visit HOMA-IR significantly decreased in group 1 (from 3.1 ± 1.7 to 2.3 ± 0.9; p = 0.02) while it remained unchanged in group 2 (from 3.0 ± 1.4 to 2.8 ± 1.2; p = 0.14) (between groups p = 0.009). At 12 weeks follow-up visit patients of both groups obtained a significant increase of ischemic threshold at ergometric test, compared to baseline, (group 1 from 308.4 ± 45 s to 423.9 ± 57 s, p = 0.0004); (group 1 from 315.7 ± 63 s to 441.2 ± 51 s, p = 0.0001); without between groups difference (p = 0.25). Conclusions Our data suggest that starting R, instead of increasing the dose of beta-blockers/calcium-channel blockers, could be a preferable choice in obese/overweight CHD subjects with residual ischemia after revascularization.

KW - Coronary heart disease

KW - Insulin resistance

KW - Ranolazine

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U2 - 10.1016/j.ijcard.2016.06.003

DO - 10.1016/j.ijcard.2016.06.003

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