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Myocardial ischemia is related to reduced ATP fluxes and energy supply leading to disturbances of intracellular ion stability in cardiac muscle cells. From current era, raised persistent (late) sodium current was recommended to contribute to disturbed ion stability by increasing intracellular sodium concentration following with elevation of intracellular calcium. The treatment of angina is specific with prevention of disease development by risk reduction.
The new anti-ischemic drug ranolazine is a specific late sodium current inhibitor which reduces sodium overload and enhances disturbed ion stability. This is related with symptomatic improvement of angina. Additionally, ranolazine shows anti-arrhythmic effects. Contraindications may occur in some cases or may remain unrelieved from anginal discomfort with conventional drug therapy. Among newer alternatives, ranolazine indirectly reduces the intracellular calcium overload associated with cardiac ischemia. It is known as a valid addition to traditional therapy. Recent reports showed some potential side effects of ranolazine in the arrhythmia therapy. This review offers an overview of the essential principles of ranolazine within the treatment of myocardial ischemia and assessing its applications in the new field of anti-arrhythmic effects. The review also outlines the different analytical methods carried out for determination of ranolazine.