- The antianginal agent ranolazine (Ranexa) improves HbA1c without increasing hypoglycemia risk in patients with chronic stable angina and diabetes mellitus (DM).
Why this matters
- Over half of patients with ischemic heart disease have abnormal glucose metabolism.
- Meta-analysis of 7 clinical trials with 6543 participants randomly allocated to ranolazine vs placebo for 8-24 weeks.
- Funding: None disclosed.
- Statistically significant HbA1c reduction for ranolazine vs placebo of 0.36% (P=.0004).
- Among patients with diabetes, mean HbA1c reduction difference for ranolazine vs placebo was 0.41% (P<.00001>
- No statistically significant difference in fasting plasma glucose between ranolazine and placebo groups (mean difference, −2.58 mmol/L in favor of ranolazine; P=.25).
- Among patients with diabetes, hypoglycemia incidence did not differ between treatment groups (OR, 1.70; P=.61).
- Small number of trials; glycemia not primary outcome.
- Heterogeneity of study populations.
- Short duration in some studies.
- Publication bias potential.