MERLIN-TIMI 36: Metabolic Efficiency With Ranolazine for Less Ischemia in Non-ST Elevation Acute Coronary Syndromes

Luis Gruberg, MD, FACC


April 30, 2007

In This Article


  1. There was an 8% relative reduction in the primary endpoint with ranolazine, which was not statistically significant.

  2. There was no effect on cardiovascular death or MI.

  3. The results provide supportive evidence for the efficacy of ranolazine as an antianginal in a broad population.

  4. Potential antiarrhythmic effects of ranolazine suggested by a significant reduction in arrhythmias warrant additional investigation.


The MERLIN-TIMI 36 trial shows that the use of ranolazine can be extended to a broader population of patients than previously studied who present with an acute coronary syndrome. The supportive evidence of its antianginal effects, coupled with a surprising antiarrhythmic effect, will enhance the confidence of this drug and likely will expand its use. It will be interesting to see a more detailed description of this antiarrhythmic effect and future dedicated studies.


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