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Metabolic Modulators for Chronic Cardiac Ischemia

Department of Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ

Bramah Singh, MD

Department of Medicine, University of California, Los Angeles

Rohit Arora, MD

Department of Medicine, Chicago Medical School, Chicago, IL

Many patients with ischemic heart disease continue to experience anginal symptoms despite revascularization and treatment with antianginal medications. The effectiveness of current anti-ischemic medications is limited by their hemodynamic side effects, such as hypotension and bradycardia, which result in compromised organ perfusion. In this article, we review five novel agents (ranolazine, trimetazidine, L-carnitine, ribose, and dichloroacetate) under investigation for treatment of ischemic heart disease that work by enhancing the efficiency of the myocardium, rather than decreasing its work. This new paradigm promises to eliminate these side effects.

Key Words: ischemia • angina • coronary heart disease

Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 10, No. 4, 217-223 (2005)
DOI: 10.1177/107424840501000402


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