PDF(Pubmed)
Abstract：
BACKGROUND: Ranolazine is a second-line drug for the management of chronic coronary syndromes (CCS). Glucose-lowering and endothelial effects have also been reported with this agent. However, whether ranolazine may improve short-term glycemic variability (GV), strictly related to the prognosis of patients with type 2 diabetes (T2D), is unknown. Thus, we aimed to explore the effects of adding ranolazine to standard anti-ischemic and glucose-lowering therapy on long- and short-term GV as well as on endothelial function and oxidative stress in patients with T2D and CCS.
METHODS: Patients starting ranolazine (n = 16) were evaluated for short-term GV, haemoglobin 1Ac (Hb1Ac) levels, endothelial-dependent flow-mediated vasodilation (FMD), and oxidative stress levels at enrolment and after 3-month follow-up. The same measurements were collected from 16 patients with CCS and T2D that did not receive ranolazine, matched for age, gender, and body mass index.
RESULTS: A significant decline in Hb1Ac levels was reported after 3-month ranolazine treatment (mean change -0.60%; 2-way ANOVA p = 0.025). Moreover, among patients receiving ranolazine, short-term GV indexes were significantly improved over time compared with baseline (p = 0.001 for time in range; 2-way ANOVA p = 0.010). Conversely, no significant changes were reported in patients without ranolazine. Finally, greater FMD and lower oxidative stress levels were observed in patients on ranolazine at 3 months.
CONCLUSIONS: Ranolazine added to standard anti-ischemic and glucose-lowering therapy demonstrated benefit in improving the glycemic status of patients with T2D and CCS. How this improvement contributes to the overall myocardial benefit of ranolazine requires further studies.
METHODS: Patients starting ranolazine (n = 16) were evaluated for short-term GV, haemoglobin 1Ac (Hb1Ac) levels, endothelial-dependent flow-mediated vasodilation (FMD), and oxidative stress levels at enrolment and after 3-month follow-up. The same measurements were collected from 16 patients with CCS and T2D that did not receive ranolazine, matched for age, gender, and body mass index.
RESULTS: A significant decline in Hb1Ac levels was reported after 3-month ranolazine treatment (mean change -0.60%; 2-way ANOVA p = 0.025). Moreover, among patients receiving ranolazine, short-term GV indexes were significantly improved over time compared with baseline (p = 0.001 for time in range; 2-way ANOVA p = 0.010). Conversely, no significant changes were reported in patients without ranolazine. Finally, greater FMD and lower oxidative stress levels were observed in patients on ranolazine at 3 months.
CONCLUSIONS: Ranolazine added to standard anti-ischemic and glucose-lowering therapy demonstrated benefit in improving the glycemic status of patients with T2D and CCS. How this improvement contributes to the overall myocardial benefit of ranolazine requires further studies.
摘要：
背景：雷诺嗪是治疗慢性冠脉综合征（CCS）的二线药物。还报道了这种药物的降糖和内皮作用。然而,雷诺嗪是否可以改善短期血糖变异性（GV），与2型糖尿病（T2D）患者的预后严格相关，是未知的。因此，我们旨在探讨在标准抗缺血降糖治疗中加入雷诺嗪对T2D和CCS患者长期和短期GV以及内皮功能和氧化应激的影响.
方法：对开始服用雷诺嗪的患者（n=16）进行短期GV评估，血红蛋白1Ac（Hb1Ac）水平，内皮依赖性血流介导的血管舒张（FMD），招募时和3个月随访后的氧化应激水平。从未接受雷诺嗪的16例CCS和T2D患者中收集相同的测量值，年龄相匹配，性别,和体重指数。
结果：雷诺嗪治疗3个月后，Hb1Ac水平显着下降（平均变化-0.60％；双向方差分析p=0.025）。此外，在接受雷诺嗪的患者中，与基线相比,短期GV指数随时间显著改善(时间范围p=0.001;双向方差分析p=0.010).相反，没有雷诺嗪的患者无显著变化.最后,在服用雷诺嗪3个月的患者中观察到更高的FMD和更低的氧化应激水平.
结论：雷诺嗪添加到标准抗缺血降糖治疗中，在改善T2D和CCS患者的血糖状态方面显示出益处。这种改善如何有助于雷诺嗪的整体心肌益处需要进一步研究。
方法：对开始服用雷诺嗪的患者（n=16）进行短期GV评估，血红蛋白1Ac（Hb1Ac）水平，内皮依赖性血流介导的血管舒张（FMD），招募时和3个月随访后的氧化应激水平。从未接受雷诺嗪的16例CCS和T2D患者中收集相同的测量值，年龄相匹配，性别,和体重指数。
结果：雷诺嗪治疗3个月后，Hb1Ac水平显着下降（平均变化-0.60％；双向方差分析p=0.025）。此外，在接受雷诺嗪的患者中，与基线相比,短期GV指数随时间显著改善(时间范围p=0.001;双向方差分析p=0.010).相反，没有雷诺嗪的患者无显著变化.最后,在服用雷诺嗪3个月的患者中观察到更高的FMD和更低的氧化应激水平.
结论：雷诺嗪添加到标准抗缺血降糖治疗中，在改善T2D和CCS患者的血糖状态方面显示出益处。这种改善如何有助于雷诺嗪的整体心肌益处需要进一步研究。
