Colchicine for prevention of post-cardiac procedure atrial fibrillation: Meta-analysis of randomized controlled trials

Mohsin Salih, Aiman Smer, Richard Charnigo, Mohamed Ayan, Yousef H. Darrat, Mahmoud Traina, Gustavo X. Morales, Luigi Di Biase, Andrea Natale, Claude S. Elayi

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background Development of atrial fibrillation after certain cardiac procedures is a common medical problem. The inflammatory process plays an important role in the pathogenesis of post-cardiac procedure atrial fibrillation (PCP-AF). Colchicine, a potent anti-inflammatory agent, has been used in several studies to reduce the risk of PCP-AF. This meta-analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy of colchicine in prevention of PC-PAF. Methods We searched PubMed, EMBASE, Web of Science, Cochrane Library database and Google Scholar for RCTs, using terms “Atrial fibrillation, atrial, or fibrillation and colchicine”. The primary end-point was the occurrence of AF post cardiac procedure, which includes cardiac surgery or pulmonary vein isolation. The safety end point was the occurrence of any side effects. Estimated odds ratios (OR) and 95% confidence intervals (CI) were evaluated. Results A total of six RCTs were included in this meta-analysis, enrolling a total of 1257 patients. Colchicine significantly reduced the odds of PCP-AF (OR 0.52; 95% CI, 0.40–0.68, P < 0.001, I2 = 0%). However, occurrence of side effects was significantly higher with colchicine when compared to placebo (OR 2.10; 95% CI, 1.34–3.30, P < 0.001, I2 = 0%). The number needed to treat is 7 and the number needed to harm is 11.2. The proportion of patients discontinuing treatment was 16%. Conclusion This meta-analysis shows that colchicine is an effective drug for prevention of PCP-AF. Colchicine could be considered as a prophylaxis to reduce PCP-AF, with some risk of treatment discontinuation due to the poor gastrointestinal tolerance (diarrhea).

Original languageEnglish (US)
Pages (from-to)258-262
Number of pages5
JournalInternational Journal of Cardiology
Volume243
DOIs
StatePublished - Sep 15 2017
Externally publishedYes

Fingerprint

Colchicine
Atrial Fibrillation
Meta-Analysis
Randomized Controlled Trials
Odds Ratio
Confidence Intervals
Library Science
Numbers Needed To Treat
Pulmonary Veins
PubMed
Thoracic Surgery
Diarrhea
Anti-Inflammatory Agents
Placebos
Databases
Safety
Therapeutics
Pharmaceutical Preparations

Keywords

  • Atrial fibrillation
  • Colchicine
  • Post cardiac procedure atrial fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Colchicine for prevention of post-cardiac procedure atrial fibrillation : Meta-analysis of randomized controlled trials. / Salih, Mohsin; Smer, Aiman; Charnigo, Richard; Ayan, Mohamed; Darrat, Yousef H.; Traina, Mahmoud; Morales, Gustavo X.; Di Biase, Luigi; Natale, Andrea; Elayi, Claude S.

In: International Journal of Cardiology, Vol. 243, 15.09.2017, p. 258-262.

Research output: Contribution to journalArticle

Salih, Mohsin ; Smer, Aiman ; Charnigo, Richard ; Ayan, Mohamed ; Darrat, Yousef H. ; Traina, Mahmoud ; Morales, Gustavo X. ; Di Biase, Luigi ; Natale, Andrea ; Elayi, Claude S. / Colchicine for prevention of post-cardiac procedure atrial fibrillation : Meta-analysis of randomized controlled trials. In: International Journal of Cardiology. 2017 ; Vol. 243. pp. 258-262.
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abstract = "Background Development of atrial fibrillation after certain cardiac procedures is a common medical problem. The inflammatory process plays an important role in the pathogenesis of post-cardiac procedure atrial fibrillation (PCP-AF). Colchicine, a potent anti-inflammatory agent, has been used in several studies to reduce the risk of PCP-AF. This meta-analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy of colchicine in prevention of PC-PAF. Methods We searched PubMed, EMBASE, Web of Science, Cochrane Library database and Google Scholar for RCTs, using terms “Atrial fibrillation, atrial, or fibrillation and colchicine”. The primary end-point was the occurrence of AF post cardiac procedure, which includes cardiac surgery or pulmonary vein isolation. The safety end point was the occurrence of any side effects. Estimated odds ratios (OR) and 95{\%} confidence intervals (CI) were evaluated. Results A total of six RCTs were included in this meta-analysis, enrolling a total of 1257 patients. Colchicine significantly reduced the odds of PCP-AF (OR 0.52; 95{\%} CI, 0.40–0.68, P < 0.001, I2 = 0{\%}). However, occurrence of side effects was significantly higher with colchicine when compared to placebo (OR 2.10; 95{\%} CI, 1.34–3.30, P < 0.001, I2 = 0{\%}). The number needed to treat is 7 and the number needed to harm is 11.2. The proportion of patients discontinuing treatment was 16{\%}. Conclusion This meta-analysis shows that colchicine is an effective drug for prevention of PCP-AF. Colchicine could be considered as a prophylaxis to reduce PCP-AF, with some risk of treatment discontinuation due to the poor gastrointestinal tolerance (diarrhea).",
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T1 - Colchicine for prevention of post-cardiac procedure atrial fibrillation

T2 - Meta-analysis of randomized controlled trials

AU - Salih, Mohsin

AU - Smer, Aiman

AU - Charnigo, Richard

AU - Ayan, Mohamed

AU - Darrat, Yousef H.

AU - Traina, Mahmoud

AU - Morales, Gustavo X.

AU - Di Biase, Luigi

AU - Natale, Andrea

AU - Elayi, Claude S.

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N2 - Background Development of atrial fibrillation after certain cardiac procedures is a common medical problem. The inflammatory process plays an important role in the pathogenesis of post-cardiac procedure atrial fibrillation (PCP-AF). Colchicine, a potent anti-inflammatory agent, has been used in several studies to reduce the risk of PCP-AF. This meta-analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy of colchicine in prevention of PC-PAF. Methods We searched PubMed, EMBASE, Web of Science, Cochrane Library database and Google Scholar for RCTs, using terms “Atrial fibrillation, atrial, or fibrillation and colchicine”. The primary end-point was the occurrence of AF post cardiac procedure, which includes cardiac surgery or pulmonary vein isolation. The safety end point was the occurrence of any side effects. Estimated odds ratios (OR) and 95% confidence intervals (CI) were evaluated. Results A total of six RCTs were included in this meta-analysis, enrolling a total of 1257 patients. Colchicine significantly reduced the odds of PCP-AF (OR 0.52; 95% CI, 0.40–0.68, P < 0.001, I2 = 0%). However, occurrence of side effects was significantly higher with colchicine when compared to placebo (OR 2.10; 95% CI, 1.34–3.30, P < 0.001, I2 = 0%). The number needed to treat is 7 and the number needed to harm is 11.2. The proportion of patients discontinuing treatment was 16%. Conclusion This meta-analysis shows that colchicine is an effective drug for prevention of PCP-AF. Colchicine could be considered as a prophylaxis to reduce PCP-AF, with some risk of treatment discontinuation due to the poor gastrointestinal tolerance (diarrhea).

AB - Background Development of atrial fibrillation after certain cardiac procedures is a common medical problem. The inflammatory process plays an important role in the pathogenesis of post-cardiac procedure atrial fibrillation (PCP-AF). Colchicine, a potent anti-inflammatory agent, has been used in several studies to reduce the risk of PCP-AF. This meta-analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy of colchicine in prevention of PC-PAF. Methods We searched PubMed, EMBASE, Web of Science, Cochrane Library database and Google Scholar for RCTs, using terms “Atrial fibrillation, atrial, or fibrillation and colchicine”. The primary end-point was the occurrence of AF post cardiac procedure, which includes cardiac surgery or pulmonary vein isolation. The safety end point was the occurrence of any side effects. Estimated odds ratios (OR) and 95% confidence intervals (CI) were evaluated. Results A total of six RCTs were included in this meta-analysis, enrolling a total of 1257 patients. Colchicine significantly reduced the odds of PCP-AF (OR 0.52; 95% CI, 0.40–0.68, P < 0.001, I2 = 0%). However, occurrence of side effects was significantly higher with colchicine when compared to placebo (OR 2.10; 95% CI, 1.34–3.30, P < 0.001, I2 = 0%). The number needed to treat is 7 and the number needed to harm is 11.2. The proportion of patients discontinuing treatment was 16%. Conclusion This meta-analysis shows that colchicine is an effective drug for prevention of PCP-AF. Colchicine could be considered as a prophylaxis to reduce PCP-AF, with some risk of treatment discontinuation due to the poor gastrointestinal tolerance (diarrhea).

KW - Atrial fibrillation

KW - Colchicine

KW - Post cardiac procedure atrial fibrillation

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