Key result
Colchicine significantly reduced the incidence of atrial fibrillation in post-cardiac surgery patients (RR 0.70) and post-ablation patients, but showed no significant benefit in patients with coronary artery disease.
Why the study?
To understand why colchicine might be beneficial in AF and synthesize studies evaluating its effect against AF.
Does colchicine reduce the incidence or recurrence of atrial fibrillation in patients undergoing cardiac surgery, PVI/ablation, or with coronary artery disease?
Meta-Analysis (n=12,344)
Does colchicine reduce the incidence or recurrence of atrial fibrillation in patients undergoing cardiac surgery, PVI/ablation, or with coronary artery disease?
Relative Risk: 0.7 (95% CI 0.58–0.84)
p-value: p=0.0001
Colchicine effectively reduces the incidence of atrial fibrillation following cardiac surgery and pulmonary vein isolation, but does not significantly prevent AF in patients with coronary artery disease.
Colchicine is a potent anti-inflammatory agent whose benefits have been explored for various conditions, including atrial fibrillation (AF). In this article, we tried to understand why colchicine might be beneficial in AF and reviewed various studies that looked at the effect of colchicine against AF. We followed the PRISMA algorithm and undertook a literature search to identify studies with control groups that looked at the effect of colchicine against AF and conducted a meta-analysis. We identified six studies on post-cardiac surgical patients, three on post-pulmonary vein isolation (PVI)/ablation patients, and two on coronary artery disease. In patients who underwent cardiac surgery, we found that colchicine is beneficial against postoperative atrial fibrillation (POAF) with a relative risk (RR) of 0.70 (95% CI of 0.58 to 0.84) and a p-value of 0.0001. We also found that in patients who underwent PVI/ablation, colchicine is beneficial in decreasing AF recurrence over three months with an RR of 0.57 (95% CI of 0.39 to 0.83) and a p-value of 0.0032 and over 12 months follow-up with an RR of 0.58 (95% CI of 0.42 - 0.80) and a p-value of 0.0008. Our meta-analysis showed that in patients with coronary artery disease, colchicine had no significant benefit in decreasing the incidence of AF with a hazard ratio (HR) of 0.86 (95% CI of 0.69 - 1.06) and a p-value of 0.16. From this study, we conclude that colchicine may be beneficial for decreasing the incidence of AF in post-cardiac surgery patients and post-PVI/ablation patients. It may not decrease the incidence of AF in patients with coronary artery disease.
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Kommu et al. (2023) conducted a meta-analysis in Atrial Fibrillation (n=12,344). Colchicine vs. Placebo or control was evaluated on Incidence of postoperative atrial fibrillation (POAF) in post-cardiac surgery patients (RR 0.70, 95% CI 0.58-0.84, p=0.0001). Colchicine significantly reduced the incidence of atrial fibrillation in post-cardiac surgery patients (RR 0.70) and post-ablation patients, but showed no significant benefit in patients with coronary artery disease.
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