Colchicine reduced major adverse cardiac events by 23% compared to standard of care in patients with acute coronary syndromes, with an odds ratio of 0.77 and a credible interval of 0.62 to 0.95.
Meta-Analysis (n=71,478)
Yes
Do anti-inflammatory therapies reduce major adverse cardiac events in patients with acute coronary syndromes or stable coronary artery disease?
Colchicine significantly reduces major adverse cardiac events in both acute coronary syndromes and stable coronary artery disease, supporting its role in secondary prevention.
Effect estimate: OR 0.77 (95% CI 0.62-0.95)
Background Anti-inflammatory therapies have been increasingly investigated for the reduction of cardiovascular (CV) events. The objective of this paper was to summarize and compare the relative effectiveness of anti-inflammatory medications for the reduction of CV events in patients with known coronary artery disease (CAD), either acute coronary syndromes (ACS) or stable CAD. Methods Systematic review and network meta-analysis of randomised controlled trials (RCTs) that included at least one anti-inflammatory treatment and involved patients with CAD. Databases searched: Medline, Embase, Cochrane Central Register of Controlled Trials, clinical trial registry websites, Europe PMC, and conference abstracts. Bayesian network meta-analysis was performed to calculate risk estimates using fixed-effects analyses in patients with ACS and stable CAD. Risk of bias assessments were performed using the Cochrane Risk of Bias 2 (RoB2) tool. Results 17,021 studies were screened; 41 met inclusion criteria. 29,487 patients were included in the ACS network and 41,791 in the stable CAD network. In the ACS network analysis, both non-steroidal anti-inflammatory drugs OR: 0.30, 95% Credible Limits (CrI): 0.11–0.74 and colchicine (OR: 0.77, CrI: 0.62–0.95) were associated with a significant reduction in major adverse cardiac events (MACE) compared to control. In the stable CAD analysis, both corticosteroids (OR: 0.44, 95% CrI: 0.26–0.72) and colchicine (OR: 0.65, CrI: 0.54–0.77) were associated with a significant reduction in MACE compared to control. Conclusions In patients with ACS, colchicine was associated with a reduction in MACE, while observed associations for NSAIDs were derived from sparse and predominantly indirect evidence. In patients with stable CAD, colchicine and corticosteroids were associated with a reduction in MACE, although these findings were informed largely by indirect comparisons. Systematic Review Registration Identifier CRD42022303289.
Boczar et al. (Wed,) conducted a meta-analysis in Coronary Artery Disease (n=71,478). Colchicine vs. Standard of care was evaluated on Major adverse cardiac events (MACE) (OR 0.77, 95% CI 0.62-0.95). Colchicine reduced major adverse cardiac events by 23% compared to standard of care in patients with acute coronary syndromes, with an odds ratio of 0.77 and a credible interval of 0.62 to 0.95.
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