Background

High-sensitive cardiac troponin tests help predict outcomes for patients with atrial fibrillation (AF). However, there is limited research on how long-term treatments affect troponin levels in AF patients without heart disease or heart failure.

Study Overview

This study, part of the RATe control in Atrial Fibrillation (RATAF) II research, looked at how six months of treatment with two medications, diltiazem and metoprolol, impacted troponin levels in patients with permanent AF.

Methods

The study involved 93 patients (28 women, average age 71) with permanent AF and normal heart function. Patients were randomly assigned to receive either:

diltiazem 360 mg (49 patients)
metoprolol 100 mg (44 patients)

Both medications were taken once daily for six months. Blood tests were conducted at rest and during exercise at the start, after one month, and after six months of treatment.

Results

After six months, both medications significantly reduced heart rates at rest and during exercise. Troponin levels also decreased:

At rest: diltiazem (p = 0.008), metoprolol (p = 0.03)
During exercise: diltiazem (p < 0.001), metoprolol (p = 0.004)

There were no significant differences between the two treatment groups.

Conclusions

Both diltiazem and metoprolol effectively lowered troponin levels in patients with permanent AF over six months. More research is needed to see if this reduction improves patient outcomes.