Drug may offer dual benefit for type 2 diabetics with angina

Tue, 12 Mar 2013
A drug used to treat patients with stable angina can prevent chest pain in people with diabetes who also suffer from angina, according to a study reported in the Journal of the American College of Cardiology.

Researchers in the US carried out the first randomized, double-blind trial to assess the effectiveness of Ranolazine (Ranexa) in reducing chest pain among people with type 2 diabetes, who are more likely to suffer angina and other symptoms of coronary heart disease than non-diabetics.

The 8-week trial involved 949 patients from 14 countries who were all diagnosed with type 2 diabetes and experienced at least one episode of angina per week. Nearly all of the patients suffered from high blood pressure (hypertension) and three-quarters had experienced a heart attack.

The participants were randomly split into either a ranolazine group or a placebo group, and after 8 weeks the researchers found that weekly episodes of angina was significantly less among those treated with ranolazine. This group also had a considerably lower average weekly use of another angina-treating drug, nitroglycerin, compared with the placebo.

Lead author of the study, Dr. Kosiborod, from Saint Luke's Mid America Heart Institute, Kansas City, said: "Angina is associated with worse quality of life, increased risk of hospitalization and higher health care costs, and appears to be more prevalent in patients with diabetes.

"While ranolazine was shown to be effective in reducing angina in prior studies, this is the first time it has been prospectively evaluated in patients with diabetes - a high-risk and therapeutically challenging group."

The research team also noted that the reduction in the weekly frequency of angina was "more pronounced" in patients with higher baseline blood sugar levels, suggesting that the drug may also help improve glycemic control in type 2 diabetic patients.

Dr. Kosiborod concluded: "Ranolazine is an effective anti-anginal drug in patients with diabetes, and may also have a glucose-lowering effect. If the glucose-lowering action of ranolazine is confirmed in future studies, patients with diabetes and angina may derive a dual benefit from this drug."
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