Colchicine in Patients With Coronary Disease Who Underwent Coronary Artery Bypass Surgery: A Meta-Analysis of Randomized Controlled Trials

• Published in: The American journal of cardiology Vol. 231; pp. 48 - 54
• Main Authors: Kirov, Hristo, Caldonazo, Tulio, Runkel, Angelique, Medin, Darko, Fischer, Johannes, Dallan, Luis Roberto, Mukharyamov, Murat, Mejia, Omar A., Jatene, Fabio B., Doenst, Torsten
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15-11-2024; Elsevier Limited
• Subjects: Angina pectoris; Body mass index; Bypass; Cardiovascular disease; Cardiovascular diseases; Chronic obstructive pulmonary disease; Clinical trials; Colchicine; coronary artery bypass grafting; Coronary artery disease; Coronary vessels; Creatinine; Data analysis; Diabetes; Disease control; Ejection fraction; Endothelium; Heart diseases; Heart surgery; Hypertension; Meta-analysis; Mortality; Neutrophils; Outliers (statistics); postoperative atrial fibrillation; Sensitivity analysis; Surgery; United States > US; postoperative atrial fibrillation; colchicine; coronary artery bypass grafting
• ISSN: 0002-9149; 1879-1913; 1879-1913
• DOI: 10.1016/j.amjcard.2024.09.003

Recent randomized evidence has shown that low-dose colchicine lowers the risk of cardiovascular events in patients with chronic coronary artery disease. Colchicine has also been used in coronary artery bypass grafting (CABG), with individual studies suggesting protective effects for postoperative atrial fibrillation (POAF). We performed a meta-analysis of studies assessing the effect of colchicine on outcomes in CABG surgery. We systematically searched 3 libraries (MEDLINE, Web of Science, and the Cochrane Library), selecting all randomized control trials including patients who underwent CABG and were randomized for perioperative administration of colchicine versus standard of care. The primary outcome was incidence of POAF. The inverse variance method (DerSimonian&Laird) and random-effects model were performed. The leave-one-out analysis was carried out as a sensitivity analysis to address possible outliers. From 205 screened studies, 5 met the inclusion criteria and were selected. The data from 839 patients were included in the final analysis. The included studies were published between 2014 and 2022. The perioperative administration of colchicine was associated with the reduction of POAF rates after CABG compared with standard of care (relative risk 0.54, 95% confidence interval 0.40 to 0.73, p <0.01). The leave-one-out analysis confirmed the robustness of the analysis, with minimal variations of the confidence interval. This meta-analysis of randomized studies suggests that the perioperative administration of colchicine is associated with significant reduction of POAF after CABG.