Improved Rate Control Reduces Cardiac Troponin T Levels in Permanent Atrial Fibrillation
Background Detectable levels of troponins are often found in serum of patients with atrial fibrillation (AF), and recent reports suggest that Tn concentrations are independently related to patient prognosis. Hypothesis We hypothesized that treatment with common rate‐reducing drugs might lower the le...
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| Published in: | Clinical cardiology (Mahwah, N.J.) Vol. 37; no. 7; pp. 422 - 427 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
New York
Wiley Periodicals, Inc
01-07-2014
John Wiley & Sons, Inc |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Background
Detectable levels of troponins are often found in serum of patients with atrial fibrillation (AF), and recent reports suggest that Tn concentrations are independently related to patient prognosis.
Hypothesis
We hypothesized that treatment with common rate‐reducing drugs might lower the levels of cardiac troponin T (TnT) in patients with permanent AF. We also wanted to investigate whether the different drugs would impact the Tn levels differently.
Methods
Sixty patients were included (mean age 71 ± 9 years, 18 women) in this randomized crossover study. All patients had stable, permanent AF without ischemic heart disease or congestive heart failure. Diltiazem 360 mg, verapamil 240 mg, metoprolol 100 mg, and carvedilol 25 mg were administered once daily for 3 weeks, in a randomized sequence. At baseline and on the last day of each treatment period, TnT concentrations were measured at rest and after a maximal exercise test.
Results
TnT was detectable in all patients. In 22% of the patients, TnT concentrations were above the threshold normally used for diagnosing myocardial infarction. All drugs reduced the levels of TnT significantly compared with baseline (P < 0.001 for all), but there were no significant differences between the treatments. Levels of TnT increased significantly in response to exercise testing (P < 0.001 for all).
Conclusions
Elevated TnT was demonstrated in a large proportion of stable patients with permanent AF without ischemic heart disease. A moderate reduction of heart rate by the study drugs was associated with a significant reduction in levels of TnT. |
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| Bibliography: | The authors have no other funding, financial relationships, or conflicts of interest to disclose. The authors disclose the following possible conflicts of interest: Dr. Ulimoen is a member of the boards of Sanofi‐Aventis and MSD and has received payment for lectures, including service on speakers bureaus, for Boehringer Ingelheim and MSD. Dr Gjesdal is a member of the board of Sanofi‐Aventis and has received payment for lectures, including service on speakers bureaus, for AstraZeneca, Meda, MSD, and Nycomed. Dr. Tveit is a member of the boards of Bayer, Bristol Myers Squibb, MSD, and Sanofi‐Aventis; has served as a consultant for Bayer, Boehringer Ingelheim, and Sanofi‐Aventis; has received payment for lectures, including service on speakers bureaus, for Nycomed and Pfizer; and has received payment for development of educational presentations for Nycomed. This work was supported by the South‐Eastern Norway Regional Health Authority and by the Medical Research Foundation, Bærum Hospital, Norway. All study drugs were paid for by the study group, and none of the manufacturers was involved in any part of the study planning, execution, or interpretation. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23 |
| ISSN: | 0160-9289 1932-8737 |
| DOI: | 10.1002/clc.22281 |