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Colchicine for stroke prevention in patients with coronary artery disease: a systematic review and meta-analysis
A H Katsanos1,2, L Palaiodimou2, C Price3
1Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, ON, Canada.
Insights
Colchicine treatment significantly lowers stroke risk in patients with coronary artery disease. This finding suggests a potential role for colchicine in preventing cerebrovascular events, warranting further investigation.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Pharmacology
Background:
- Clinical trials indicate colchicine may reduce vascular events in coronary artery disease (CAD) patients.
- The impact of colchicine on preventing cerebrovascular events remains uncertain.
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials (RCTs) on colchicine's effect on incident strokes in cardiovascular disease (CVD) patients.
Main Methods:
- A systematic review and meta-analysis of RCTs was conducted.
- Studies included patients with a history of CVD randomized to colchicine or control groups.
- Incident strokes during follow-up were the primary outcome.
Main Results:
- Four RCTs with 5553 patients were analyzed.
- Colchicine significantly reduced stroke risk (risk ratio 0.31; 95% CI 0.13-0.71) with no heterogeneity.
- Low-dose colchicine may prevent one stroke in 161 CAD patients over 23 months.
Conclusions:
- Colchicine treatment demonstrably decreases stroke risk in patients with a history of coronary artery disease.
- Ongoing trials are further evaluating colchicine's efficacy in secondary stroke prevention.
Background And Purpose:
Although clinical trials suggest that colchicine may reduce the risk of vascular events in patients with a history of coronary artery disease, its effect on the prevention of cerebrovascular events still remains unclear.
Methods:
A systematic review and meta-analysis was performed of all available randomized controlled trials (RCTs) reporting on incident strokes during the follow-up of patients with a history of cardiovascular disease randomized to colchicine treatment or control (placebo or usual care).
Results:
Four RCTs were identified, including a total of 5553 patients (mean age 61 years, 81% males), with a follow-up ranging from 1 to 36 months. Colchicine treatment was associated with a significantly lower risk of incident stroke during follow-up compared to control (risk ratio 0.31, 95% confidence interval 0.13-0.71), without heterogeneity across included studies (I2 = 0%). Based on the pooled incident stroke rate of control groups (0.9%) in the included RCTs, it was estimated that administration of low-dose colchicine to 161 patients with coronary artery disease would prevent one stroke during a follow-up of 23 months.
Conclusion:
Colchicine treatment decreases stroke risk in patients with a history of coronary artery disease. The effect of colchicine in secondary stroke prevention is currently being evaluated in an ongoing RCT.
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