Preoperative Colchicine and Conduction Disturbances After Transcatheter Aortic Valve Implantation: A US Retrospective...

Conduction disturbances are frequent complications following transcatheter aortic valve intervention (TAVI), partially driven by inflammation. The anti-inflammatory role of colchicine on these disorders post TAVI has not been studied yet. Therefore, we investigated the association between preoperative colchicine use and conduction disturbances after TAVI.

We used the TriNetX platform, a data repository of health record data from health care organizations in the United States, to identify patients receiving any colchicine prescription within 3 months before their first TAVI and compared them to propensity score matched patients never exposed to colchicine up to 1 year after the procedure. Primary outcomes included new-onset or worsening atrioventricular or left bundle-branch block (LBBB) and heart block (HB) postoperatively. Outcomes were assessed within 1 and 6 months after TAVI with an E-sensitivity analysis assessing the impact of unmeasured confounders.

Of 52 860 patients, 705 were on preoperative colchicine. After matching, each group included 702 patients. Colchicine was associated with a statistically significant reduction of new-onset or worsening atrioventricular/left bundle-branch block and heart block post TAVI at 1 month (relative risk [RR], 0.867 [95% CI, 0.756-0.994], P=0.041; RR, 0.887 [95% CI, 0.788-0.999], P=0.047, respectively) but not at 6 months (RR, 0.886 [95% CI, 0.779-1.077], P=0.064; RR, 0.913 [95% CI, 0.817-1.020], P=0.109, respectively). The E-value was >1.5 for the statistically significant outcomes.

Preoperative colchicine was associated with a lower incidence of new-onset or worsening atrioventricular/left bundle-branch block and heart block after TAVI at 1 month. However, no significant difference was observed at 6 months. Future prospective studies are needed to evaluate the definitive role of colchicine in improving TAVI outcomes.