Related Experiment Video
Updated: Apr 4, 2026
In Silico Clinical Trials for Cardiovascular Disease
Published on: May 27, 2022
Colchicine in cardiac disease: a systematic review and meta-analysis of randomized controlled trials
Subodh Verma1,2,3, John W Eikelboom4, Stefan M Nidorf5
1Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada. vermasu@smh.ca.
Insights
Colchicine, an anti-inflammatory drug, significantly reduced cardiovascular adverse outcomes by approximately 60% in patients with established cardiovascular disease. It also decreased recurrent pericarditis and atrial fibrillation after cardiac surgery, though diarrhea was a common side effect.
Area of Science:
- Cardiology
- Pharmacology
- Inflammation Research
Background:
- Colchicine possesses anti-inflammatory properties with potential benefits in cardiovascular conditions.
- This systematic review and meta-analysis evaluates randomized controlled trials (RCTs) on colchicine's efficacy in cardiac diseases.
Purpose of the Study:
- To systematically review and meta-analyze RCTs assessing colchicine's impact on cardiovascular outcomes.
- To investigate colchicine's effect on specific cardiac conditions like pericarditis and atrial fibrillation.
Main Methods:
- Searched MEDLINE, EMBASE, and Cochrane Database for RCTs involving colchicine in adult cardiac patients.
- Pooled results from 15 RCTs (n=3431) using random effects meta-analysis.
- Analyzed data on composite cardiovascular outcomes, mortality, recurrent pericarditis, and atrial fibrillation.
Main Results:
- Colchicine reduced composite cardiovascular outcomes by ~60% (RR 0.44, p=0.0004) in patients at risk.
- Showed a trend towards lower all-cause mortality (RR 0.50, p=0.08).
- Decreased recurrent pericarditis/post-pericardiotomy syndrome (RR 0.50, p<0.0001) and peri-procedural atrial fibrillation (RR 0.65, p=0.0003).
- Diarrhea was the most common adverse event; discontinuation rates were higher with colchicine.
Conclusions:
- Colchicine may reduce cardiovascular adverse outcomes in patients with existing cardiovascular disease.
- Colchicine effectively reduces rates of recurrent pericarditis, post-pericardiotomy syndrome, and peri-procedural atrial fibrillation.
- Further RCTs are warranted to explore colchicine's role in secondary cardiovascular event prevention.
Background:
Colchicine has unique anti-inflammatory properties that may be beneficial in various cardiovascular conditions. This systematic review and meta-analysis of randomized controlled trials (RCTs) examines this issue.
Methods:
We searched MEDLINE, EMBASE, and the Cochrane Database from inception to June 2014 for RCTs using colchicine in adult patients with cardiac diseases. Results were pooled using random effects.
Results:
15 RCTs (n = 3431 patients, median treatment 3 and follow-up 15 months) were included. All but 2 used colchicine 1 mg/day. In 5 trials, n = 1301) at risk for cardiovascular disease (coronary artery disease, acute coronary syndrome or stroke, post-angioplasty [2 RCTs], or congestive heart failure), colchicine reduced composite cardiovascular outcomes by ~60 % (risk ratio [RR] 0.44, 95 % confidence interval [CI] 0.28-0.69, p = 0.0004; I(2) = 0 %) and showed a trend towards lower all-cause mortality (RR 0.50, 95 % CI 0.23-1.08, p = 0.08; I(2) = 0 %). In pericarditis or post-cardiotomy, colchicine decreased recurrent pericarditis or post-pericardiotomy syndrome (RR 0.50, 95 % CI 0.41-0.60, p < 0.0001; I(2) = 0 %; 8 RCTs, n = 1635), and post-pericardiotomy or ablation induced atrial fibrillation (RR 0.65, 95 % CI 0.51-0.82, p = 0.0003; I(2) = 31 %; 4 RCTs, n = 1118). The most common adverse event was diarrhea. Treatment discontinuation overall and due to adverse events (RR 4.34, 95 % CI 1.70-11.07, p = 0.002; I(2) = 29 %; 7 RCTs, 83/790 [10.5 %] vs. 11/697 [1.6 %]) was higher in colchicine-assigned patients.
Conclusions:
Current RCT data suggests that colchicine may reduce the composite rate of cardiovascular adverse outcomes in a range of patients with established cardiovascular disease. Furthermore, colchicine reduces rates of recurrent pericarditis, post-pericardiotomy syndrome, and peri-procedural atrial fibrillation following cardiac surgery. Further RCTs evaluating the potential of colchicine for secondary prevention of cardiovascular events would be of interest.
