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Updated: Jun 14, 2025
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Colchicine in Patients With Coronary Disease Who Underwent Coronary Artery Bypass Surgery: A Meta-Analysis of
Hristo Kirov1, Tulio Caldonazo1, Angelique Runkel1
1Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Jena, Germany.
Insights
Low-dose colchicine significantly reduces the risk of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting (CABG). This finding supports colchicine
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Recent evidence indicates low-dose colchicine reduces cardiovascular events in chronic coronary artery disease.
- Colchicine has shown potential protective effects against postoperative atrial fibrillation (POAF) in coronary artery bypass grafting (CABG) surgery.
Purpose of the Study:
- To conduct a meta-analysis of randomized controlled trials (RCTs) evaluating the effect of colchicine on outcomes in CABG surgery.
- To specifically assess the impact of perioperative colchicine on the incidence of POAF.
Main Methods:
- Systematic literature search of MEDLINE, Web of Science, and Cochrane Library.
- Inclusion of RCTs comparing perioperative colchicine with standard care in CABG patients.
- Meta-analysis using the inverse variance method and a random-effects model; sensitivity analysis via leave-one-out.
Main Results:
- Five RCTs involving 839 patients met the inclusion criteria.
- Perioperative colchicine administration was associated with a significant reduction in POAF rates (RR 0.54, 95% CI 0.40-0.73, p<0.01).
- Leave-one-out analysis confirmed the robustness of the findings.
Conclusions:
- Perioperative colchicine administration significantly reduces the incidence of POAF following CABG.
- The findings support the use of colchicine as a potential therapeutic strategy to mitigate POAF risk in CABG patients.
Abstract:
Recent randomized evidence has shown that low-dose colchicine lowers the risk of cardiovascular events in patients with chronic coronary artery disease. Colchicine has also been used in coronary artery bypass grafting (CABG), with individual studies suggesting protective effects for postoperative atrial fibrillation (POAF). We performed a meta-analysis of studies assessing the effect of colchicine on outcomes in CABG surgery. We systematically searched 3 libraries (MEDLINE, Web of Science, and the Cochrane Library), selecting all randomized control trials including patients who underwent CABG and were randomized for perioperative administration of colchicine versus standard of care. The primary outcome was incidence of POAF. The inverse variance method (DerSimonian&Laird) and random-effects model were performed. The leave-one-out analysis was carried out as a sensitivity analysis to address possible outliers. From 205 screened studies, 5 met the inclusion criteria and were selected. The data from 839 patients were included in the final analysis. The included studies were published between 2014 and 2022. The perioperative administration of colchicine was associated with the reduction of POAF rates after CABG compared with standard of care (relative risk 0.54, 95% confidence interval 0.40 to 0.73, p <0.01). The leave-one-out analysis confirmed the robustness of the analysis, with minimal variations of the confidence interval. This meta-analysis of randomized studies suggests that the perioperative administration of colchicine is associated with significant reduction of POAF after CABG.
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