Does preoperative colchicine reduce new-onset or worsening atrioventricular or left bundle-branch block and heart block in patients undergoing TAVI?
Preoperative colchicine may reduce the incidence of early (1-month) conduction disturbances following TAVI, though this benefit does not appear to persist at 6 months.
BACKGROUND: Conduction disturbances are frequent complications following transcatheter aortic valve intervention (TAVI), partially driven by inflammation. The anti-inflammatory role of colchicine on these disorders post TAVI has not been studied yet. Therefore, we investigated the association between preoperative colchicine use and conduction disturbances after TAVI. METHODS: We used the TriNetX platform, a data repository of health record data from health care organizations in the United States, to identify patients receiving any colchicine prescription within 3 months before their first TAVI and compared them to propensity score matched patients never exposed to colchicine up to 1 year after the procedure. Primary outcomes included new-onset or worsening atrioventricular or left bundle-branch block (LBBB) and heart block (HB) postoperatively. Outcomes were assessed within 1 and 6 months after TAVI with an E-sensitivity analysis assessing the impact of unmeasured confounders. RESULTS: =0.109, respectively). The E-value was >1.5 for the statistically significant outcomes. CONCLUSIONS: Preoperative colchicine was associated with a lower incidence of new-onset or worsening atrioventricular/left bundle-branch block and heart block after TAVI at 1 month. However, no significant difference was observed at 6 months. Future prospective studies are needed to evaluate the definitive role of colchicine in improving TAVI outcomes.
Abdelsayed et al. (Tue,) studied this question.