Key result
Inpatient colchicine for acute gout in ADHF linked to ~84% lower in-hospital mortality.
Why the study?
Although colchicine is often used to manage acute gout in heart failure patients, its impact on clinical outcomes during acute decompensated heart failure is unknown.
Does colchicine for acute gout reduce in-hospital all-cause mortality in patients hospitalized for acute decompensated heart failure?
Cohort (n=1,047)
No
Does colchicine for acute gout reduce in-hospital all-cause mortality in patients hospitalized for acute decompensated heart failure?
Hazard Ratio: 0.163 (95% CI 0.051–0.525)
Absolute Event Rate: 2.1% vs 6.5%
p-value: p=0.002
Colchicine use for acute gout flares during hospitalizations for acute decompensated heart failure was associated with significantly lower in-hospital mortality.
Colchicine for gout in acute decompensated HF was associated with lower in-hospital mortality; hypothesis-generating and requires prospective confirmation before practice change.
BACKGROUND: Gout is a common comorbidity in heart failure (HF) patients and is frequently associated with acute exacerbations during treatment for decompensated HF. Although colchicine is often used to manage acute gout in HF patients, its impact on clinical outcomes when used during acute decompensated HF is unknown. METHODS: This was a single center, retrospective study of hospitalized patients treated for an acute HF exacerbation with and without acute gout flare between March 2011 and December 2020. We assessed clinical outcomes in patients treated with colchicine for a gout flare compared to those who did not experience a gout flare or receive colchicine. The primary outcome was in-hospital all-cause mortality. RESULTS: Among 1047 patient encounters for acute HF during the study period, there were 237 encounters (22.7%) where the patient also received colchicine for acute gout during admission. In-hospital all-cause mortality was significantly reduced in the colchicine group compared with the control group (2.1% vs. 6.5%, p = .009). The colchicine group had increased length of stay (9.93 vs. 7.96 days, p < .001) but no significant difference in 30-day readmissions (21.5% vs. 19.5%, p = .495). In a Cox proportional hazards model adjusted for age, inpatient colchicine use was associated with improved survival to discharge (hazards ratio [HR] 0.163, 95% confidence interval [CI] 0.051-0.525, p = .002) and a reduced rate of in-hospital CV mortality (HR 0.184, 95% CI 0.044-0.770, p = .021). CONCLUSION: Among patients with a HF exacerbation, treatment with colchicine for a gout flare was associated with significantly lower in-hospital mortality compared with those not treated for acute gout.
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Roth et al. (2022) conducted a cohort in Acute decompensated heart failure (n=1,047). Colchicine vs. No colchicine and no gout flare was evaluated on In-hospital all-cause mortality (HR 0.163, 95% CI 0.051-0.525, p=0.002). Inpatient colchicine use for acute gout flare in patients with acute decompensated heart failure was associated with significantly lower in-hospital all-cause mortality (2.1% vs 6.5%, HR 0.163).
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