Cardio-protective role of ranolazine during percutaneous coronary intervention in chronic coronary syndrome patients

Objectives: Chronic coronary syndrome (CCS) is a major cause of morbidity and mortality. Despite advances in percutaneous coronary intervention (PCI), patients remain at risk for PCI-related myocardial injury (PMI). The best pharmacological strategy to reduce PMI in high-risk patients is still uncle...

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Main Authors: Ahmed G.Bakry, Hossam Eldin M Mahmoud, Areej Alkhateeb, Mohammed H. Hassan, Marwa Abdelhady
Format: Article
Language:English
Published: Center for Scientific Research and Development of Education. 2025-05-01
Series:Heart Vessels and Transplantation
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Online Access:http://hvt-journal.com/articles/art566
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Summary:Objectives: Chronic coronary syndrome (CCS) is a major cause of morbidity and mortality. Despite advances in percutaneous coronary intervention (PCI), patients remain at risk for PCI-related myocardial injury (PMI). The best pharmacological strategy to reduce PMI in high-risk patients is still unclear. This study evaluates the cardio-protective role of ranolazine in reducing PMI in CCS patients, focusing on cardiac troponin I (cTnI) levels. Methods: A prospective observational study enrolled 72 CCS patients undergoing PCI, divided into two groups: standard care (Group I, n=36) and ranolazine (Group II, n=36). Serum cTnI levels were measured at baseline and 24 hours post-PCI using chemiluminescent immunoassay. The primary endpoint was post-PCI cTnI comparison, with secondary endpoints including delta change in cTnI levels, cTnI elevation above the upper reference limit (URL), and correlation between procedure time and post-PCI cTnI levels. Results: The ranolazine group showed a significant reduction in post-PCI cTnI levels compared to the standard care group (0.1925 (0.33) vs. 0.4517 (0.66) ng/mL, p=0.004). The delta change in cTnI was also lower in the ranolazine group (0.1531 (0.33) vs. 0.4128 (0.66) ng/mL, p=0.005). Fewer patients in the ranolazine Group had cTnI levels above the URL (9 vs. 19, p=0.029) as compared to standard care group. A significant positive correlation between procedure time and cTnI levels was found in the standard care group but not in the ranolazine group. Conclusion: Ranolazine reduced PCI-related myocardial injury, suggesting its potential as an adjunct therapy for CCS patients. Further research is needed to confirm its clinical efficacy and long-term benefits.
ISSN:1694-7886
1694-7894