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Effect of ranolazine on A1C and glucose levels in hyperglycemic patients with non-ST elevation acute coronary syndrome . OBJECTIVE We determined the relationships between glycemia at randomization , concurrent antidiabetic therapy , and change in A1C and fasting plasma glucose ( FPG ) in patients with diabetes receiving standard treatment for diabetes and randomized to ranolazine or placebo within the MERLIN-TIMI-36 ( MERLIN ) study . Ranolazine is a novel first-in-class drug approved for treating angina pectoris . RESEARCH DESIGN AND METHODS Randomization and 4-month glycemic and antidiabetes drug usage data from MERLIN were analyzed using Spotfire and SAS version 9.1 software . RESULTS In patients with diabetes and A1C of > or=8-10 % at randomization ( n = 171 ) , there was an absolute A1C reduction in the ranolazine group of 1.2 % ( 95 % CI -1.4 to -1.0 ) , and the placebo-adjusted ( n = 182 ) decrease in A1C by ranolazine was 0.59 % ( 95 % CI -0.99 to -0.20 , P < 0.001 ) . In patients with FPG of 150-400 mg/dl at randomization , ranolazine ( n = 131 ) compared with placebo ( n = 147 ) reduced FPG by 25.7 mg/dl ( 95 % CI -43.3 to -8.1 , P = 0.001 ) . When changes in either A1C or FPG were correlated to A1C or FPG at randomization , the slopes were significantly steeper for ranolazine than placebo ( A1C , P = 0.046 ; FPG , P < 0.001 ) , indicating that lowering of A1C and FPG by ranolazine is related to hyperglycemia at randomization . Ranolazine , compared with placebo , was not associated with serious hypoglycemic events , associated with significant changes in concurrent antidiabetic therapy , or dependent on a history of angina . CONCLUSIONS Ranolazine , when added to concurrent antidiabetes treatment , lowers FPG and A1C in patients with cardiovascular disease and poorly controlled diabetes .
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Intervention_Pharmacological
ranolazine
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Intervention_Pharmacological
ranolazine
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Intervention_Control
placebo
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Intervention_Pharmacological
Ranolazine
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Intervention_Pharmacological
glycemic
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Intervention_Pharmacological
antidiabetes drug usage
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Intervention_Pharmacological
ranolazine
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Intervention_Control
placebo-adjusted
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Intervention_Pharmacological
ranolazine
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Intervention_Control
placebo
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Intervention_Pharmacological
ranolazine
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Intervention_Control
placebo
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Intervention_Pharmacological
ranolazine
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Intervention_Pharmacological
Ranolazine
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Outcome_Physical
A1C reduction
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Outcome_Physical
A1C
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Outcome_Physical
A1C or FPG
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Outcome_Physical
A1C or FPG
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Outcome_Physical
A1C and FPG
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Outcome_Adverse-effects
serious hypoglycemic events
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Outcome_Other
concurrent antidiabetic therapy
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Outcome_Physical
history of angina
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Outcome_Physical
FPG and A1C
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Participant_Condition
hyperglycemic patients
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Participant_Condition
acute coronary syndrome
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Participant_Condition
diabetes