Effects of Ranolazine on Recurrent Cardiovascular Events in Patients With Non–ST-Elevation Acute Coronary Syndromes&lt;SUBTITLE&gt;The MERLIN-TIMI 36 Randomized Trial&lt;/SUBTITLE&gt;

Morrow, David A.; Scirica, Benjamin M.; Karwatowska‐Prokopczuk, Ewa; Murphy, Sabina A.; Budaj, Andrzej; Varshavsky, Sergei; Wolff, Andrew; Skene, Allan M.; McCabe, Carolyn H.; Braunwald, Eugene

doi:10.1001/jama.297.16.1775

Cited by 453 publications

(333 citation statements)

References 19 publications

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“…Ranolazine is approved for the treatment of chronic angina pectoris (therapeutic plasma level of 2-10 μM) and has been shown to have minimal side-effects in patients. 38,39 In conclusion, although extrapolation from the HEK293 expression system to paramyotonia congenita patients should be done with caution, ranolazine may have the ability to block excessive and sustained firing of action potentials in these patients.…”

Section: ©2 0 1 1 L a N D E S B I O S C I E N C E D O N O T D I S Tmentioning

confidence: 95%

Ranolazine block of human Na_v1.4 sodium channels and paramyotonia congenita mutants

El-Bizri¹,

Kahlig²,

Shyrock³

et al. 2011

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Section: ©2 0 1 1 L a N D E S B I O S C I E N C E D O N O T D I S Tmentioning

confidence: 95%

Ranolazine block of human Na_v1.4 sodium channels and paramyotonia congenita mutants

El-Bizri¹,

Kahlig²,

Shyrock³

et al. 2011

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“…Ranolazine did not improve the primary end point of death, myocardial infarction, or recurrent chronic stable angina requiring further revascularization. Equally, nonbeneficial effects (major cardiovascular events, including cardiovascular death and myocardial infarction) were found in the MERLIN trial 64 involving patients with non-ST-segment elevation acute coronary syndrome.…”

Section: Key Points For Ranolazinementioning

confidence: 99%

“…• In patients enrolled in the MERLIN trial 64 , ranolazine significantly reduced glycated haemoglobin (HbA1c) levels. Therefore, patients with diabetes and chronic stable angina might benefit from ranolazine treatment.…”

Section: Other (Considered Second-choice Treatment In Guidelines)mentioning

confidence: 99%

A 'diamond' approach to personalized treatment of angina

et al. 2017

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Chronic stable angina pectoris is the most prevalent symptomatic manifestation of ischaemic heart disease, and its management is a priority (BOX 1). Current clinical guidelines recommend antianginal therapy to control symptoms, before considering coronary artery revasculariza tion [1][2][3][4] . However, revascularization by either percutaneous coronary angioplasty or CABG surgery is indicated in patients who have significant artery steno sis (50% left main narrowing or proximal three-vessel disease) to reduce myocardial ischaemia and its adverse clinical manifestation. Antianginal agents are approved by documenting that they improve total exercise duration, together with a reduction in daily frequency of chronic stable angina compared with placebo and/or equivalence to an active comparator. Cardiovascular outcomes, although highly advocated, are not a pre requisite for regulatory approval. None of the antianginal drugs has been proved to reduce cardiovascular mortality or the rate of myocardial infarction. When patients are optimally treated, mortality for chronic stable angina is low, which might explain why all trials designed to improve prognosis have been negative. Guidelines recom mend a first-choice and a second-choice approach, based more on tradition and expert opinion, rather than evidence. This categorical approach has been questioned in the past couple of years 5-8 . Newer antianginal drugs, which are classified as second choice, have more evidence-based clinical data that are more contemporary to support their use than is available for the traditional first-choice drugs. Equally, the often-needed combin ation of double or triple therapy is based on expert opinion and not related to the underlying pathophysio logy. What constitutes optimal antianginal treatment, therefore, varies considerably between countries, and the majority of doctors treat their patients according to their own preconceptions.A group of experts with experience and interest in chronic stable angina met at the University of Ferrara, Italy, to discuss an individualized approach to medical treatment of chronic stable angina, on the basis E X P E RT C O N S E N S U S D O C U M E N TA 'diamond' approach to personalized treatment of angina Abstract | In clinical guidelines, drugs for symptomatic angina are classified as being first choice (β-blockers, calcium-channel blockers, short-acting nitrates) or second choice (ivabradine, nicorandil, ranolazine, trimetazidine), with the recommendation to reserve second-choice medications for patients who have contraindications to first-choice agents, do not tolerate them, or remain symptomatic. No direct comparisons between first-choice and second-choice treatments have demonstrated the superiority of one group of drugs over the other. Meta-analyses show that all antianginal drugs have similar efficacy in reducing symptoms, but provide no evidence for improvement in survival. The newer, second-choice drugs have more evidence-based clinical data that are more contemporary than is available for tr...

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“…W badaniu Metabolic Efficiency With Ranolazine for Less Ischaemia in Non-ST-Elevation Acute Coronary Syndromes (MERLIN) dowiedziono, że ranolazyna -lek zapobiegający przeładowaniu komórek wapniem w niedokrwieniu -u 3279 pacjentów z NSTE-ACS nie powodował zmniejszenia częstości poważnych zdarzeń sercowych w porównaniu z placebo. W badaniu tym wykazano jednak, że ranolazyna powodowała zmniejszenie odsetka nawrotów niedokrwienia [125]. Można rozważyć stosowanie antagonistów wapnia i ranolazyny u pacjentów, których nie można poddać skutecznej rewaskularyzacji, a mimo stosowania beta-adrenolityku występuje u nich dławica.…”

Section: Inne Klasy Lekówunclassified

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Roffi¹,

Patrono²,

Collet³

et al. 2015

Kardiol Pol

207

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Effects of Ranolazine on Recurrent Cardiovascular Events in Patients With Non–ST-Elevation Acute Coronary Syndromes<SUBTITLE>The MERLIN-TIMI 36 Randomized Trial</SUBTITLE>

Abstract: clinicaltrials.gov Identifier: NCT00099788.

Cited by 453 publications

References 19 publications

Ranolazine block of human Na_v1.4 sodium channels and paramyotonia congenita mutants

Ranolazine block of human Na_v1.4 sodium channels and paramyotonia congenita mutants

A 'diamond' approach to personalized treatment of angina

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

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Effects of Ranolazine on Recurrent Cardiovascular Events in Patients With Non–ST-Elevation Acute Coronary Syndromes<SUBTITLE>The MERLIN-TIMI 36 Randomized Trial</SUBTITLE>

Abstract: clinicaltrials.gov Identifier: NCT00099788.

Cited by 453 publications

References 19 publications

Ranolazine block of human Nav1.4 sodium channels and paramyotonia congenita mutants

Ranolazine block of human Nav1.4 sodium channels and paramyotonia congenita mutants

A 'diamond' approach to personalized treatment of angina

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

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Product

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Ranolazine block of human Na_v1.4 sodium channels and paramyotonia congenita mutants

Ranolazine block of human Na_v1.4 sodium channels and paramyotonia congenita mutants