IMR Press / RCM / Volume 23 / Issue 12 / DOI: 10.31083/j.rcm2312387
Open Access Systematic Review
Colchicine for Prevention of Post-Cardiac Surgery and Post-Pulmonary Vein Isolation Atrial Fibrillation: A Meta-Analysis
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1 Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
2 National Clinical Research Center for Cardiovascular Diseases, 100029 Beijing, China
*Correspondence: liunian1973@hotmail.com (Nian Liu)
Academic Editors: Giuseppe Nasso and Giuseppe Santarpino
Rev. Cardiovasc. Med. 2022, 23(12), 387; https://doi.org/10.31083/j.rcm2312387
Submitted: 8 July 2022 | Revised: 27 August 2022 | Accepted: 5 September 2022 | Published: 28 November 2022
(This article belongs to the Special Issue New Insights in Treatment of Atrial Fibrillation)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Post-cardiac procedure atrial fibrillation (PCP-AF) is a significant medical problem. Inflammation is one of the key factors in the pathogenesis of PCP-AF. As a classical anti-inflammatory drug, colchicine may prevent the occurrence of PCP-AF. This meta-analysis of 12 randomized controlled trials (RCTs) analyzed the feasibility and safety of colchicine for the prevention of PCP-AF. Methods: PubMed, EMBASE, Web of Science, the Cochrane Library, and Google Scholar were retrieved for RCTs on the efficacy of colchicine in preventing atrial fibrillation. The primary endpoint was the diagnosis of PCP-AF, which includes cardiac surgery or pulmonary vein isolation. Evaluation was performed with estimated odds ratios (OR) and 95% confidence intervals (CI). Results: In this meta-analysis, 12 RCTs were selected and a total of 2297 patients were included. Colchicine therapy was associated with a reduced incidence of PCP-AF both in post-cardiac surgery (OR: 0.62; 95% CI: 0.49–0.78, p < 0.0001, I2 = 0%), and in post-pulmonary vein isolation (OR: 0.43; 95% CI: 0.30–0.62, p < 0.0001, I2 = 0%). Colchicine therapy was associated with increased side effects (OR: 2.81; 95% CI: 1.96–4.03, p < 0.00001, I2 = 26%). Conclusion: Colchicine can effectively prevent post-cardiac operative atrial fibrillation and relapse of atrial fibrillation after pulmonary vein isolation (PVI). However, colchicine can also increase the incidence of side effects, mainly gastrointestinal adverse events. More studies are needed to find a more appropriate treatment dose and time.

Keywords
colchicine
atrial fibrillation
post-cardiac surgery atrial fibrillation
post-pulmonary vein isolation
Funding
82170318/National Science Foundation of China
81870244/National Science Foundation of China
Figures
Fig. 1.
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