Ranolazine Improves Glycemic Variability and Endothelial Function in Patients with Diabetes and Chronic Coronary Syndromes: Results from an Experimental Study
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 pa...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2021/4952447 |
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| _version_ | 1832566424077336576 |
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| author | Annunziata Nusca Federico Bernardini Fabio Mangiacapra Ernesto Maddaloni Rosetta Melfi Elisabetta Ricottini Francesco Piccirillo Silvia Manfrini Gian Paolo Ussia Francesco Grigioni |
| author_facet | Annunziata Nusca Federico Bernardini Fabio Mangiacapra Ernesto Maddaloni Rosetta Melfi Elisabetta Ricottini Francesco Piccirillo Silvia Manfrini Gian Paolo Ussia Francesco Grigioni |
| author_sort | Annunziata Nusca |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-995b144b25a149c2a2ebebdaa6cf3b76 |
| institution | Kabale University |
| issn | 2314-6753 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-995b144b25a149c2a2ebebdaa6cf3b762025-02-03T01:04:17ZengWileyJournal of Diabetes Research2314-67532021-01-01202110.1155/2021/4952447Ranolazine Improves Glycemic Variability and Endothelial Function in Patients with Diabetes and Chronic Coronary Syndromes: Results from an Experimental StudyAnnunziata Nusca0Federico Bernardini1Fabio Mangiacapra2Ernesto Maddaloni3Rosetta Melfi4Elisabetta Ricottini5Francesco Piccirillo6Silvia Manfrini7Gian Paolo Ussia8Francesco Grigioni9Unit of Cardiac SciencesUnit of Cardiac SciencesUnit of Cardiac SciencesDepartment of Experimental MedicineUnit of Cardiac SciencesUnit of Cardiac SciencesUnit of Cardiac SciencesUnit of Endocrinology and DiabetesUnit of Cardiac SciencesUnit of Cardiac SciencesBackground. 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.http://dx.doi.org/10.1155/2021/4952447 |
| spellingShingle | Annunziata Nusca Federico Bernardini Fabio Mangiacapra Ernesto Maddaloni Rosetta Melfi Elisabetta Ricottini Francesco Piccirillo Silvia Manfrini Gian Paolo Ussia Francesco Grigioni Ranolazine Improves Glycemic Variability and Endothelial Function in Patients with Diabetes and Chronic Coronary Syndromes: Results from an Experimental Study Journal of Diabetes Research |
| title | Ranolazine Improves Glycemic Variability and Endothelial Function in Patients with Diabetes and Chronic Coronary Syndromes: Results from an Experimental Study |
| title_full | Ranolazine Improves Glycemic Variability and Endothelial Function in Patients with Diabetes and Chronic Coronary Syndromes: Results from an Experimental Study |
| title_fullStr | Ranolazine Improves Glycemic Variability and Endothelial Function in Patients with Diabetes and Chronic Coronary Syndromes: Results from an Experimental Study |
| title_full_unstemmed | Ranolazine Improves Glycemic Variability and Endothelial Function in Patients with Diabetes and Chronic Coronary Syndromes: Results from an Experimental Study |
| title_short | Ranolazine Improves Glycemic Variability and Endothelial Function in Patients with Diabetes and Chronic Coronary Syndromes: Results from an Experimental Study |
| title_sort | ranolazine improves glycemic variability and endothelial function in patients with diabetes and chronic coronary syndromes results from an experimental study |
| url | http://dx.doi.org/10.1155/2021/4952447 |
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