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Myocardial biomarkers in coronary microvascular dysfunction: Response to ranolazine

Year: 2025
Type: article
Abstract: Introduction: Patients with coronary microvascular dysfunction (CMD) are at increased risk of developing heart failure with preserved ejection fraction (HFpEF). We hypothesized that higher myocardial biomarkers (ultra-high sensitivity cardiac troponin I [u-hs-TnI]) and ventricular dysfunction (N-terminal pro-BNP [NT-proBNP]) would be related to greater ischemia improvement on the late sodium channel inhibitor ranolazine. Methods: We analyzed CMD participants with baseline myocardial biomarkers randomized to ranolazine or placebo (RWISE trial: NCT01342029). Ischemia response was change in global myocardial perfusion reserve index (∆MPRI) or Seattle Angina Questionnaire (∆SAQ). Results: = 0.80) on ranolazine. There was no relation with NT-proBNP. Conclusions: These findings suggest that higher u-hs-TnI signals greater ischemia improvement on ranolazine. Further studies evaluating ischemia therapies in CMD are needed to develop potential HFpEF prevention targets.
DOI: 10.1016/j.ahjo.2025.100513
Authors: Katherine E. Hampilos, Anum Asif, Puja K. Mehta, Daniel S. Berman, Galen Cook-Wiens, Michael D. Nelson, Carl J. Pepine, C. Noel Bairey Merz, Janet Wei
Institutions: Cedars-Sinai Smidt Heart Institute, The University of Texas at San Antonio, Emory University, Cedars-Sinai Medical Center, S. Mark Taper Foundation, The University of Texas at Arlington, University of Florida
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,810
Funders: U.S. Department of Defense, American Heart Association, Gustavus and Louise Pfeiffer Research Foundation, Gilead Sciences, University of Florida, Deutsches Krebsforschungszentrum, Cedars-Sinai Medical Center, National Institutes of Health, Clinical and Translational Science Institute, University of Florida, National Heart, Lung, and Blood Institute, National Center for Research Resources, National Center for Advancing Translational Sciences, Clinical and Translational Science Institute, University of California, Los Angeles
Awards: G1134269671, G1313999278, G1545794908, UCLA Clinical and Translational Science Institute, Functional myocardial ischemia as a mechanism of diastolic dysfunction in women with coronary microvascular dysfunction, Together: Transforming and Translating Discovery to Improve Health, EVAL OF ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CTR, G2386482314, G2663518188, G276921238, EVAL OF ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CTR, ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CENTER, UCLA Clinical and Translational Science Institute, Advanced 3T for Structural and Functional Imaging at University of Florida, G3637194313, ISCHEMIC HEART DISEASE IN WOMEN--CLINICAL CENTER, G432001851, Women's Ischemia Syndrome Evaluation (WISE) Coronary Vascular Dysfunction, General Clinical Research Center, G7781681247, G950221744
OpenAlex ID: W4407821115
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Cites: 9
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Related to: 10