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Abstrait

CoVid-19 Cardiac Complications: Is an Easy, Safe Treatment Strategy Right Under Our Noses?

Gary L. Murray

Abstract
Background: Many chronic conditions, as diabetes (DM) and cardiovascular Diseases, suffer Major Adverse Cardiac Events (MACE): i myocarditis, congestive heart failure (CHF), Ventricular Tachycardia (VT), Ventricular Fibrillation (VF), Acute Coronary Syndromes [ACSs], and Sudden Cardiac Death (SCD) Acute infections, like COVID-19,also involve oxidative stress, leading to increased Sympathetic tone (S) and decreased Parasympathetic tone (P), increasing Sympathovagal Balance (SB) and MACE.The antioxidant (r)alpha lipoic acid(ALA) improves SB. The anti-anginal Ranolazine (RAN), also an antioxidant,.is an anti-arrhythmic.  Our studies of their effects on MACE, in DM, and non-DM patients with CHF, ventricular arrhythmias and SCD are reviewed herein, as our findings may apply to acute diseases, such as COVID-19.

Methods: (1) In a case-control study, 109 CHF patients, 54 were given adjunctive off-label RAN added to ACC/AHA Guideline therapy (RANCHF).MACE and SB were compared with 55 NORANCHF patients; mean f/u 23.7 mo.

(2) 59 adults with triggered premature ventricular contractions (PVCs), bigeminy, and VT were given off-label RAN.  Pre- and post-RAN Holters were compared; mean f/u 3.1 mo.

(3) 133 DM II with cardiac diabetic autonomic neuropathy were offered (r)ALA; 83 accepted; 50 refused. P&S were followed a mean of 6.31 yrs, and SCDs recorded.

Results: (1) 70% of RANCHF patients increased LVEF 11.3 EFUs (p≤0.003), SCD reduced 56%; VT/VF therapies decreased 53%.

(2) 95% of patients responded: VT decreased 91% (p