What is the clinical evidence from this study?

Study design: RCT. Population: Patients undergoing non-CABG cardiac surgery (n=121). Intervention: Colchicine vs. Placebo. Primary outcome: Level of cardiac troponin T (cTnT) at postoperative 48 hours (p=<0.01).

What does this research mean for the field?

A short perioperative course of low-dose colchicine significantly reduces postoperative biomarkers of myocardial injury, such as cardiac troponin T, and decreases post-pericardiotomy syndrome in patients undergoing non-CABG cardiac surgery. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 7, 2023Critical CareOpen Access

The low-dose colchicine in patients after non-CABG cardiac surgery: a randomized controlled trial

Q: What are the key findings of this study?

A short perioperative course of low-dose colchicine significantly reduced the level of cardiac troponin T at postoperative 48 hours (median 0.3 vs 0.4 μg/L) compared to placebo in patients undergoing non-CABG cardiac surgery.

Q: What does this research mean for the field?

A short perioperative course of low-dose colchicine significantly reduces postoperative biomarkers of myocardial injury, such as cardiac troponin T, and decreases post-pericardiotomy syndrome in patients undergoing non-CABG cardiac surgery. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Perioperative low-dose colchicine lowers 48-hour cTnT by ~25% versus placebo in non-CABG cardiac surgery.

P<0.01
n=121

Why the study?

The effect of colchicine on myocardial protection in patients undergoing non-coronary artery bypass grafting with cardiopulmonary bypass remained unclear.

Does perioperative low-dose colchicine reduce myocardial injury biomarkers in patients undergoing non-CABG cardiac surgery?

Study Design

Type

RCT (n=121)

Blinding

Single-blind

Randomization

1:1

Multicenter

Structured PICO

Does perioperative low-dose colchicine reduce myocardial injury biomarkers in patients undergoing non-CABG cardiac surgery?

Population

132 adult patients (aged 50-75, NYHA I-II) undergoing on-pump non-coronary artery bypass grafting (non-CABG) cardiovascular surgery with cardiopulmonary bypass, mean age 59.4, 57.8% male, single-center in China.

Intervention

Colchicine 0.5 mg oral once daily starting 3 days before the operation and for 5 days after operation.

Comparator

Matching placebo (starch tablets) starting 3 days before the operation and for 5 days after operation.

Outcome

Level of cardiac troponin T (cTnT) at postoperative 48 hours.surrogate

Main Result

Absolute Event Rate: 0.3% vs 0.4%

p-value: p=<0.01

A short perioperative course of low-dose colchicine significantly attenuated postoperative biomarkers of myocardial injury and inflammation and decreased post-pericardiotomy syndrome in patients undergoing non-CABG cardiac surgery.

Limitations

Single-blind design may affect patients' selection and introduce bias.
The study recruited 'low-risk' patients, so the effect in 'high-risk' patients remains unexamined.
Utilized cTnT to evaluate perioperative myocardial infarction; whether colchicine improves clinical outcomes needs further confirmation.
The 0.5 mg colchicine schedule remains to be explored in the Chinese population and may not be appropriate for western people.
Some inflammatory biomarkers (IL-10, IL-8, and tumor necrosis factor-1β) were not tested.
Prolonged duration might result in significant differences in adverse endpoints if used for more than one month.
Six patients in the colchicine group had diarrhea before surgery and refused to continue the drug, leading to missing biomarker data.
Small sample size
Single-center design
Self-tested cTnI kit
Needs to be confirmed in a larger sample study to assess clinical endpoints

Discussion

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Implication

Perioperative colchicine may attenuate myocardial injury after non-CABG surgery; extends equivocal prior data.

Cite This Study

Pan et al. (2023) conducted an RCT in Patients undergoing non-CABG cardiac surgery (n=121). Colchicine vs. Placebo was evaluated on Level of cardiac troponin T (cTnT) at postoperative 48 hours (p=<0.01). A short perioperative course of low-dose colchicine significantly reduced the level of cardiac troponin T at postoperative 48 hours (median 0.3 vs 0.4 μg/L) compared to placebo in patients undergoing non-CABG cardiac surgery.

synapsesocial.com/papers/6a1747cabdf43c780a7867db https://doi.org/10.1186/s13054-023-04341-9

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The low-dose colchicine in patients after non-CABG cardiac surgery: a randomized controlled trial

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

The low-dose colchicine in patients after non-CABG cardiac surgery: a randomized controlled trial

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider