Colchicine reduced the risk of pericarditis recurrence or postpericardiotomy syndrome (OR 0.37; 95% CI 0.29-0.47; P<0.001), but increased gastrointestinal side effects (OR 2.6; 95% CI 1.82-3.72).
Meta-Analysis (n=4,064)
Does colchicine reduce the recurrence of pericarditis, postpericardiotomy syndrome, and postprocedural atrial fibrillation in patients with cardiac diseases?
Colchicine is effective for preventing recurrent pericarditis and postprocedural atrial fibrillation, but its clinical utility may be limited by significant gastrointestinal adverse events and treatment discontinuation.
Effect estimate: OR 0.37 (95% CI 0.29-0.47)
p-value: p=<0.001
AIMS: Colchicine has been suggested to be beneficial in preventing recurrent pericarditis. The goal of this study was to review all randomized controlled trials that assess the use of colchicine for the prevention and treatment of cardiac diseases. METHODS: We performed a meta-analysis of the effects of colchicine on pericarditis, postpericardiotomy syndrome and postprocedural atrial fibrillation recurrence, in-stent restenosis, gastrointestinal adverse effects, and treatment discontinuation rates. We conducted an EMBASE and MEDLINE search for prospective controlled trials. RESULTS: We identified 17 prospective controlled randomized studies with 2082 patients that received colchicine and 1982 controls with an average follow-up duration of 12 months. Treatment with colchicine is associated with reduced risk of pericarditis recurrence/postpericardiotomy syndrome (OR: 0.37; 95% CI: 0.29-0.47; P<0.001) and lower recurrence of atrial fibrillation rates after cardiac surgery and ablation procedures. However, gastrointestinal side effects were more common in patients treated with colchicine (OR: 2.6; 95% CI: 1.82-3.72; P<0.001) in all subgroups except for those treated for prevention of recurrent pericarditis. The higher rates of side effects resulted in higher incidence of treatment discontinuation in patients treated with colchicine. CONCLUSION: Colchicine appears to be efficacious and well tolerated for recurrent pericarditis/postpericardiotomy syndrome and recurrence of postprocedural atrial fibrillation. However, its efficacy may be limited by its gastrointestinal adverse events and treatment discontinuation rates particularly in postoperative patients.
Παπαγεωργίου et al. (Wed,) conducted a meta-analysis in Cardiac diseases (pericarditis, postpericardiotomy syndrome, atrial fibrillation) (n=4,064). Colchicine vs. Controls was evaluated on Pericarditis recurrence/postpericardiotomy syndrome (OR 0.37, 95% CI 0.29-0.47, p=<0.001). Colchicine reduced the risk of pericarditis recurrence or postpericardiotomy syndrome (OR 0.37; 95% CI 0.29-0.47; P<0.001), but increased gastrointestinal side effects (OR 2.6; 95% CI 1.82-3.72).
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