Diltiazem reduces levels of NT-proBNP and improves symptoms compared with metoprolol in patients with permanent atrial fibrillation.

Autor:	Enge K; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Sogneprest Munthe-kaas vei 100, 1346 Gjettum, Norway.; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway., Tveit A; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Sogneprest Munthe-kaas vei 100, 1346 Gjettum, Norway.; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway., Enger S; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Sogneprest Munthe-kaas vei 100, 1346 Gjettum, Norway., Onarheim S; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Sogneprest Munthe-kaas vei 100, 1346 Gjettum, Norway., Pripp AH; Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Domus Medica Gaustad, Sognsvannsveien 9, 0372 Oslo, Norway., Rønningen PS; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Sogneprest Munthe-kaas vei 100, 1346 Gjettum, Norway., Solberg MG; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Sogneprest Munthe-kaas vei 100, 1346 Gjettum, Norway., Byrkjeland R; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Sogneprest Munthe-kaas vei 100, 1346 Gjettum, Norway., Andresen K; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway.; Department of Cardiology, Drammen Hospital, Vestre Viken Hospital Trust, Dronninggata 28, 3004 Drammen, Norway.; ProCardio Center for Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 9, 0372 Oslo, Norway., Halsen A; Department of Medicine, Ringerike Hospital, Vestre Viken Hospital Trust, Arnold Dybsjords vei 1, 3511 Hønefoss, Norway., Aulie HA; Department of Internal Medicine, Diakonhjemmet Hospital, Diakonveien 12, 0370 Oslo, Norway.; Department of Cardiology, Oslo University Hospital Ullevål, Kirkeveien 166, 0450 Oslo, Norway., Steinsvik T; Department of Laboratory Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Sogneprest Munthe-kaas vei 100, 1346 Gjettum, Norway., Hall C; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway.; Department of Medicine, Ringerike Hospital, Vestre Viken Hospital Trust, Arnold Dybsjords vei 1, 3511 Hønefoss, Norway., Ulimoen SR; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Sogneprest Munthe-kaas vei 100, 1346 Gjettum, Norway.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular pharmacotherapy [Eur Heart J Cardiovasc Pharmacother] 2024 Oct 04; Vol. 10 (6), pp. 515-525.
DOI:	10.1093/ehjcvp/pvae032
Abstrakt:	Aims: Short-term treatment with calcium channel blockers lowers levels of N-terminal pro B-type natriuretic peptide (NT-proBNP) and reduces rhythm-related symptoms compared to treatment with beta-blockers. The aim of this study was to compare the effects of metoprolol and diltiazem for rate control in patients with permanent atrial fibrillation (AF) after 6 months. Methods and Results: Men and women with permanent AF and preserved left ventricular systolic function were randomized to receive either diltiazem 360 mg or metoprolol 100 mg once daily. The primary endpoint was the level of NT-proBNP after a 6-month treatment period. Secondary endpoints included heart rate, rhythm-related symptoms and exercise capacity. A total of 93 patients (mean age 71 ± 7 years, 28 women) were randomized. After 6-months' treatment, mean levels of NT-proBNP decreased in the diltiazem group and increased in the metoprolol group, with a significant between-group difference (409.8 pg/mL, 95% CI: 230.6-589.1, P < 0.001). Treatment with diltiazem significantly reduced rhythm-related symptoms compared to baseline, but no change was observed in the metoprolol group. Diltiazem and metoprolol had similar effects on heart rate and exercise capacity. Conclusion: Diltiazem reduced NT-proBNP levels and improved rhythm-related symptoms. Metoprolol increased peptide levels but had no impact on symptoms despite similar heart rate reduction. Non-dihydropyridine calcium channel blockers should be considered more often for rate control in permanent AF. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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