Ranolazine to Treat Acute Coronary Syndromes?

In a large, randomized trial, adding ranolazine to standard ACS treatment produced no reduction in major adverse cardiac events.

In several studies, ranolazine has reduced symptoms and increased time to angina or ST-segment depression during exercise in patients with chronic angina (Journal Watch Cardiology Apr 2 2004). Might ranolazine have a role in treating non–ST-elevation acute coronary syndromes (ACS)? To find out, investigators in the manufacturer-funded MERLIN-TIMI 36 study randomized 6560 patients (mean age, 64) with ACS symptoms to either ranolazine (intravenous for 12 to 96 hours, then 1000 mg oral twice daily) or placebo. All patients also received standard therapy: medical management in 60.5%, percutaneous intervention in 31.6%, and coronary artery bypass surgery in 7.9%. Median follow-up was 348 days.

The ranolazine and placebo groups showed no significa…

Reviewing Author

Joanne M. Foody, MD