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 DiBiase, Andrea Natale, Claude S. Elayi

Research output: Contribution to journalArticle

15 Scopus citations

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

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Salih, M., Smer, A., Charnigo, R., Ayan, M., Darrat, Y. H., Traina, M., Morales, G. X., DiBiase, L., Natale, A., & Elayi, C. S. (2017). Colchicine for prevention of post-cardiac procedure atrial fibrillation: Meta-analysis of randomized controlled trials. International Journal of Cardiology, 243, 258-262. https://doi.org/10.1016/j.ijcard.2017.04.022