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This Week in JAMA
April 25, 2007

This Week in JAMA

JAMA. 2007;297(16):1747. doi:10.1001/jama.297.16.1747

Ranolazine, a novel antianginal agent, is approved for patients with chronic angina, but whether it might benefit patients with acute coronary syndromes (ACS) is not clear. The efficacy and safety of ranolazine vs placebo in moderate- and high-risk patients with ACS who were receiving standard therapy were evaluated in the Metabolic Efficiency With Ranolazine for Less Ischemia in Non–ST-Elevation Acute Coronary Syndromes (MERLIN)-TIMI 36 randomized trial. Morrow and colleaguesArticle, writing for the trial investigators, report that compared with placebo, ranolazine was not associated with reductions in the primary efficacy outcome—a composite of cardiovascular death, myocardial infarction, or recurrent ischemia—or with the major safety end points of total mortality and symptomatic documented arrhythmia during a median follow-up of 348 days. In an editorial, Newby and PetersonArticle discuss the MERLIN trial outcomes in relation to other antiangina therapies.