Key result
Colchicine showed no significant difference in preventing new clinically important perioperative atrial fibrillation and myocardial injury at 14 days after thoracic surgery.
Why the study?
Although COP-AF showed no overall difference in POAF and MINS with colchicine, event rates differed between thoracoscopic and open surgery, prompting exploratory analyses to assess whether surgical approach modified treatment efficacy.
Does colchicine prevent perioperative atrial fibrillation or myocardial injury in patients undergoing major thoracic surgery?
RCT
Randomized
Yes
Does colchicine prevent perioperative atrial fibrillation or myocardial injury in patients undergoing major thoracic surgery?
Colchicine did not significantly reduce the incidence of perioperative atrial fibrillation or myocardial injury 14 days after major thoracic surgery.
Colchicine is a potent and inexpensive anti-inflammatory agent. Perioperative atrial fibrillation (POAF) and myocardial injury after noncardiac surgery (MINS) are 2 frequent cardiovascular complications after thoracic surgery, with acute surgical inflammation likely playing an important mechanistic role for both. The “COlchicine for the Prevention of Perioperative Atrial Fibrillation” (COP-AF) trial tested whether colchicine prevents POAF or MINS in patients undergoing thoracic surgery. The trial showed no significant difference in new clinically important POAF and MINS at 14 days after randomization.1 However, patients who underwent thoracoscopic surgery had a lower incidence of POAF and MINS compared to those who underwent open or conversion-to-open surgery. We undertook exploratory analyses of COP-AF to assess whether different surgical approaches modified the efficacy of colchicine for the POAF and MINS prevention. The trial was approved by local ethics committees and regulatory authorities in participating jurisdictions. Patients provided written informed consent.
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Wang et al. (2026) conducted an RCT in Thoracic surgery. Colchicine was evaluated on New clinically important perioperative atrial fibrillation (POAF) and myocardial injury after noncardiac surgery (MINS). Colchicine showed no significant difference in preventing new clinically important perioperative atrial fibrillation and myocardial injury at 14 days after thoracic surgery.
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