Elsevier

The American Journal of Cardiology

Volume 140, 1 February 2021, Pages 33-38
The American Journal of Cardiology

Meta-analysis Evaluating the Utility of Colchicine in Secondary Prevention of Coronary Artery Disease

https://doi.org/10.1016/j.amjcard.2020.10.043Get rights and content

Colchicine has shown potential therapeutic benefits in cardiovascular conditions owing to its broad anti-inflammatory properties. Here, we performed a meta-analysis to determine the efficacy and safety of colchicine in patients with coronary artery disease (CAD). A systematical search in electronic databases of PubMed, The Cochrane Library, and Scopus were carried out to identify eligible studies. Only randomized controlled trials evaluating the cardiovascular effects of colchicine in CAD patients were included. Study-level data of cardiovascular outcomes or adverse events were pooled using random-effect models. We finally included 5 randomized controlled trials with follow-up duration ≥6 months, comprising a total of 11,790 patients with CAD. Compared with placebo or no treatment, colchicine administration was associated with a significantly lower incidence of major adverse cardiovascular events (relative risk [RR] 0.65, 95% confidence interval [CI] 0.52 to 0.82). Such a benefit was not modified by the clinical phenotype of CAD (p for interaction = 0.34). Colchicine treatment also decreased the risk of myocardial infarction (RR 0.73, 95% CI 0.55 to 0.98), coronary revascularization (RR 0.61, 95% CI 0.42 to 0.89) and stroke (RR 0.47, 95% CI 0.28 to 0.81) in CAD patients, but with no impact on cardiovascular mortality. In addition, the rates of common adverse events were generally similar between colchicine and control groups, including noncardiovascular deaths (RR 1.50, 95% CI 0.93 to 2.40) and gastrointestinal symptoms (RR 1.05, 95% CI 0.91 to 1.22). In conclusion, the results of our meta-analysis demonstrated that colchicine treatment may reduce the risk of future cardiovascular events in CAD patients.

Section snippets

Methods

This study was performed in accordance with the preferred reporting Items for systematic reviews and meta-analyses statement.6 To obtain the potentially eligible studies, we systematically searched the databases of PubMed, The Cochrane Library, and Scopus from inception to August 2020. The terms used in the search process were as follows: (“colchicine”) AND (“coronary artery disease” OR “coronary heart disease” OR “angina” OR “myocardial infarction” OR “acute coronary syndrome [ACS]” OR

Results

The search strategy initially documented a total of 516 articles. After scanning the titles and/or abstracts, 482 reports were considered as irrelevant and were excluded. In the remaining 34 records, 29 were further removed according to the eligibility and exclusion criteria. As a consequence, 5 RCTs913 published between 2013 and 2020 were included into the final analysis (Figure 1).

The main features of the included studies and patients are summarized in Table 1. The 5 trials comprised 11,790

Discussion

In the present study of patients with a history of CAD, colchicine treatment led to a significant risk reduction in MACE, myocardial infarction, coronary revascularization, and stroke as compared with placebo or no treatment. Moreover, colchicine did not increase the rate of adverse clinical events, including noncardiovascular death and gastrointestinal events.

To date, this is the first meta-analysis demonstrating the cardiovascular benefit of colchicine in CAD patients, regardless of their

Authors’ Contributions

Meng Xia: Investigation, Data curation, Writing - Original draft preparation; Xueying Yang: Investigation, Data curation, Visualization, Supervision; Cheng Qian: Conceptualization, Methodology, Software, Writing - Review & Editing, Funding acquisition.

Disclosures

The authors have no conflicts of interest to disclose.

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    This study was supported by The Doctoral Scientific Research Startup Fund Project of the Affiliated Hospital of Southwest Medical University by Grant No. 19071, Luzhou, China.

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    Contributed equally to this work.

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