Association Between Colchicine Use and Clinical Outcomes Post Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials

Q: What are the key findings of this study?

Colchicine reduced the risk of postoperative atrial fibrillation by 30% compared with placebo in patients undergoing cardiac surgery (RR 0.70, 95% CI 0.59–0.83, p<0.001).

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Cardiac surgery (n=2005). Intervention: Colchicine vs. Placebo. Primary outcome: Postoperative atrial fibrillation (POAF) (RR 0.70, 95% CI 0.59–0.83, p=<0.001).

Q: What does this research mean for the field?

Colchicine reduces the risk of postoperative atrial fibrillation and shortens hospital stay after cardiac surgery, but does not significantly alter risks of all-cause mortality, stroke, or permanent pacemaker implantation. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the association between colchicine use and cardiovascular outcomes among patients undergoing cardiac surgery.

Vikash Jaiswal; Muhammad Hanif; Hafsa Arshad Azam Raja; Sulochana Khadka; Novonil Deb; Yusra Mashkoor; Aymen Ahmed; Kripa Rajak; Arvind Kumar Jaiswal; Mohit Gupta; Sameer A Hirji; Gregg C. Fonarow; Arman Qamar

doi:10.1007/s40256-026-00831-7

November 7, 2026American Journal of Cardiovascular DrugsOpen Access

Association Between Colchicine Use and Clinical Outcomes Post Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials

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Key result

Colchicine cuts postoperative atrial fibrillation ~30% vs. placebo after cardiac surgery.

RR 0.70
95% CI 0.59–0.83
P<0.001
n=2,005

Why the study?

Although colchicine mitigates inflammation and reduces adverse cardiovascular events, clinical trial evidence regarding its efficacy for cardiovascular prevention among patients undergoing cardiac surgery has been mixed.

Does colchicine reduce the risk of postoperative atrial fibrillation and other adverse cardiovascular outcomes in adult patients undergoing cardiac surgery?

Key Points

To evaluate the association between colchicine use and cardiovascular outcomes among patients undergoing cardiac surgery.
Systematic search of electronic databases up to July 15, 2025, for two-arm randomized controlled trials comparing colchicine to placebo in cardiac surgery patients (PROSPERO CRD420251117966).
Colchicine significantly reduced the risk of postoperative atrial fibrillation compared with placebo (RR 0.70 [95% CI 0.59–0.83], p < 0.001) and was associated with a shorter hospital stay (WMD – 1.16 [95% CI – 1.89 to – 0.44], p < 0.01).
No statistically significant differences occurred between groups for all-cause mortality (RR 0.81 [95% CI 0.39–1.69], p = 0.57, I 2 = 0%), stroke (RR 1.86 [95% CI 0.48–7.12], p = 0.37), or permanent pacemaker implantation (RR 1.36 [95% CI 0.08–22.44], p = 0.83).

Study Design

Type

Meta-Analysis (n=2,005)

Randomization

Randomized controlled trials included

Structured PICO

Does colchicine reduce the risk of postoperative atrial fibrillation and other adverse cardiovascular outcomes in adult patients undergoing cardiac surgery?

P

Population

2,005 adult patients (mean age 62.8 years) undergoing cardiac surgery across 9 randomized controlled trials comparing perioperative colchicine with placebo, followed from hospital discharge up to 6 months.

I

Intervention

Colchicine (varying perioperative and postoperative dosing regimens across trials, typically 0.5 mg to 2 mg daily/BID from pre-op/post-op up to discharge or 1 month).

C

Comparator

Placebo.

O

Outcome

Postoperative atrial fibrillation (POAF) over follow-up periods ranging from in-hospital to 6 months.hard clinical

Main Result

Relative Risk: 0.7 (95% CI 0.59–0.83)

p-value: p=<0.001

In patients undergoing cardiac surgery, perioperative colchicine reduces postoperative atrial fibrillation by 30% and shortens hospital stay without affecting mortality, stroke, or pacemaker implantation, though it increases gastrointestinal adverse events.

Limitations

Variability in colchicine dosing, treatment duration, and surgical procedures across included trials
Inconsistent reporting of cumulative colchicine exposure precluded pooled dose-response analysis
Timing of onset and duration of postoperative atrial fibrillation episodes were not uniformly documented
Heterogeneity in arrhythmia monitoring protocols (continuous telemetry vs. intermittent ECG)
Small number of included RCTs (9 trials), modest total sample size, and limited subgroup data
Inconsistent reporting of safety outcomes, particularly gastrointestinal adverse events
Potential publication bias due to lack of unpublished data
Lack of long-term follow-up evaluation for stroke and mortality beyond the study periods
Variability in colchicine dosing, treatment duration, and surgical procedures across trials may affect generalizability
Cumulative colchicine exposure was not consistently documented across trials, precluding pooled dose-response analysis
Heterogeneity in monitoring protocols (continuous telemetry vs. intermittent ECG) and lack of uniform reporting on timing and duration of POAF episodes
Small number of included RCTs, modest trial enrollment, and limited subgroup data
Inconsistent reporting of safety outcomes, particularly gastrointestinal adverse events, and potential publication bias

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Colchicine prophylaxis reduces postoperative atrial fibrillation after cardiac surgery; confirms prior RCT findings and supports guideline consideration.

Abstract

Colchicine has been shown to mitigate inflammation and reduce adverse cardiovascular events. However, evidence from clinical trials has been mixed regarding its efficacy in cardiovascular prevention among patients undergoing cardiac surgery. We aimed to evaluate the association between colchicine use and cardiovascular outcomes in patients undergoing cardiac surgery. We conducted a systematic literature search on various electronic databases for relevant studies from their inception until July 15, 2025. Randomized controlled trials (RCTs) with two arms—one with colchicine as an intervention and the other with placebo—in patients undergoing cardiac surgery were included. Risk ratios (RRs) and weighted mean differences (WMDs), along with 95% confidence intervals (CIs), were pooled using a random-effects model. A p value of < 0.05 was considered statistically significant. Nine RCTs with 2005 patients (990 in the colchicine group and 1015 in the placebo group) were included. The mean age was 62.8 years. Pooled analysis demonstrated that compared with placebo, colchicine was significantly associated with a reduction in the risk of postoperative atrial fibrillation (POAF) (RR 0.70 [95% CI 0.59–0.83], p < 0.001). However, between the groups, there was no statistically significant difference in the risk of all-cause mortality (ACM) (RR 0.81 [95% CI 0.39–1.69], p = 0.57, I 2 = 0%), stroke (RR 1.86 [95% CI 0.48–7.12], p = 0.37), and permanent pacemaker implantation (PPM) (RR 1.36 [95% CI 0.08–22.44], p = 0.83). Length of hospital stay, which was exploratory, was significantly shorter in the colchicine group (WMD – 1.16 [95% CI – 1.89 to – 0.44], p < 0.01) compared to placebo. This meta-analysis demonstrates that colchicine appears to reduce the risk of POAF. However, it does not significantly affect the risks in terms of PPM, ACM, or stroke. PROSPERO identifier no. CRD420251117966.

Discussion

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Cite This Study

Jaiswal et al. (2026) conducted a meta-analysis in Cardiac surgery (n=2,005). Colchicine vs. Placebo was evaluated on Postoperative atrial fibrillation (POAF) (RR 0.70, 95% CI 0.59–0.83, p=<0.001). Colchicine reduced the risk of postoperative atrial fibrillation by 30% compared with placebo in patients undergoing cardiac surgery (RR 0.70, 95% CI 0.59–0.83, p<0.001).

synapsesocial.com/papers/6af1d893f9a8addd138b1c6f https://doi.org/10.1007/s40256-026-00831-7

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Association Between Colchicine Use and Clinical Outcomes Post Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Association Between Colchicine Use and Clinical Outcomes Post Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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