Colchicine for Postoperative Atrial Fibrillation Prevention

According to a meta-analysis published in the Journal of Cardiothoracic Surgery, postoperative atrial fibrillation (POAF) is the most frequent complication after cardiothoracic surgery or cardiac intervention. The authors assessed the anti-inflammatory agent colchicine for prevention of POAF and described meaningful efficacy that slightly increased with longer treatment duration, and no obvious safety concerns.

The analysts enrolled 9 randomized controlled trials with a total of 2031 patients from the PubMed, Embase, ClinicalTrials.gov, Cochrane Library, and Google Scholar databases. Random-effects models were used to evaluate the primary end point, occurrence of atrial fibrillation diagnoses based on colchicine dose and duration.

Colchicine Effectively Reduces POAF After Surgery

According to the researchers, colchicine significantly reduced the incidence of POAF (risk ratio [RR], 0.62; 95% CI, 0.52-0.74; P<.001; I2=0%). Furthermore, the protection from POAF with colchicine in the long-duration group (RR, 0.60; 95% CI, 0.48-0.75; P<.001; I2=0%) was slightly higher compared with the short-duration group (RR, 0.60; 95% CI, 0.49-0.86; P<.001; I2=0%).

The authors noted they were limited by a low number of available studies on low-dose colchicine, which prevented them from comparing outcomes between low- and normal-dose colchicine. Regardless, they concluded that “colchicine can effectively prevent the occurrence of atrial fibrillation after cardiothoracic surgery or cardiac intervention.”

In closing, the authors suggested that “future studies are needed to elucidate the optimal medication duration and dosage of colchicine to improve the treatment regimen.”

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