Author + information
- Received June 15, 2015
- Revision received September 1, 2015
- Accepted September 4, 2015
- Published online February 1, 2016.
- Justin Z. Lee, MDa,
- Nirmal Singh, MDa,
- Carol L. Howe, MDb,
- See-Wei Low, MDa,
- Jennifer J. Huang, DOa,
- Gilbert Ortega, BSc,
- Kwan S. Lee, MDd,∗ ( and )
- Anil Pandit, MDe
- aDepartment of Internal Medicine, University of Arizona, Tucson, Arizona
- bArizona Health Sciences Library, University of Arizona, Tucson, Arizona
- cCollege of Medicine, University of Arizona, Tucson, Arizona
- dDepartment of Cardiovascular Diseases, University of Arizona, Tucson, Arizona
- eDeBakey Heart Institute, Hays, Kansas
- ↵∗Reprint requests and correspondence:
Dr. Kwan S. Lee, Department of Cardiovascular Disease, University of Arizona, 3950 S. Country Club Road, Suite 200, Tucson, Arizona 85714.
Objectives This study sought to investigate the efficacy and safety of colchicine for prevention of post-operative atrial fibrillation.
Background Proinflammatory processes induced during cardiac surgery may contribute toward post-operative atrial fibrillation (AF). Colchicine is a potent anti-inflammatory agent, which may have a role in post-operative AF prevention.
Methods We searched PubMed, EMBASE, Web of Science, CINAHL, ClinicalTrials.gov, and the Cochrane Library databases for randomized controlled trials (RCT) comparing colchicine versus placebo for prevention of post-operative AF. The main outcome measure of interest was the development of AF within 12 months after cardiac surgery. The overall risk ratio (RR) for the development of post-operative AF was computed using a random-effects model.
Results Data analyzed from 3 randomized studies with a total of 912 patients, where 457 patients received colchicine and 455 patients received placebo, showed that perioperative colchicine therapy was associated with a reduced incidence of post-operative AF (RR: 0.65; 95% confidence interval [CI]: 0.46 to 0.91; p < 0.01). Although colchicine therapy was associated with increased incidence of gastrointestinal intolerance (RR: 2.20; 95% CI: 1.31 to 3.70; p = 0.003), it was not associated with early treatment discontinuation (RR: 1.37; 95% CI: 0.95 to 1.96; p = 0.09).
Conclusions In conclusion, current evidence suggests that colchicine therapy is efficacious for the prevention of post-operative AF, and may be considered as adjunctive prophylaxis. Further studies may be required to determine the optimal treatment protocol to reduce the incidence of gastrointestinal intolerance.
Dr. Kwan Lee has received honoraria from St. Jude Medical and Maquet Medical Systems. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 15, 2015.
- Revision received September 1, 2015.
- Accepted September 4, 2015.
- American College of Cardiology Foundation