Meta-analysis Evaluating the Utility of Colchicine in Secondary Prevention of Coronary Artery Disease
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 RCTs9–13 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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The impact of colchicine on patients with acute and chronic coronary artery disease
2024, European Journal of Internal MedicineDrivers of mortality in patients with chronic coronary disease in the low-dose colchicine 2 trial
2023, International Journal of CardiologyCitation Excerpt :Aside from intentional overdose, colchicine has not been associated with the development of any specific disease or cause of death. [5] Tabular meta-analyses of the contemporary placebo controlled trials of long-term low-dose colchicine in patients with and without cardiovascular disease in >15,000 patients have not linked colchicine with the composite of non-cardiovascular death or any specific disease or cause of death. [13–16] In ongoing future studies, it will be important to ensure that safety meta-analyses consider disease-specific causes of death rather than the composite of non-cardiovascular mortality. [17]
The Promising Effect of Colchicine on Random-pattern Skin Flap Survival in Rats: Glutamate Pathway
2022, Journal of Surgical ResearchColchicine for Secondary Prevention of Coronary Artery Disease: A Meta-Analysis of Randomised Controlled Trials
2022, Heart Lung and CirculationCitation Excerpt :Gastrointestinal events were frequently reported in colchicine treatment of gout, pericarditis, and familial Mediterranean fever [3,20,21]. A similar rate of gastrointestinal events between the colchicine and control groups was found in this meta-analysis, which was consistent with other meta-analyses of colchicine treatment of CAD [18,19]. Subgroup analyses demonstrated a significant benefit of additional colchicine compared with control, both in patients with stable CAD and ACS.
Colchicine for Prevention of Atherothrombotic Events in Patients With Coronary Artery Disease: Review and Practical Approach for Clinicians
2021, Canadian Journal of CardiologyCitation Excerpt :Three recent meta-analyses of randomized controlled trials confirmed that colchicine decreases the risk of major cardiovascular events, MI, stroke, and coronary revascularization but not of cardiocascular death, in secondary prevention of CAD. Reassuringly, these benefits were observed without an increase in gastrointestinal safety concerns.39,40,41 The totality of the evidence regarding the role of colchicine in secondary prevention of CAD is consistent across types of patients (stable CAD, post-MI), making the causal association robust in addition to its biological plausibility.
Inflammation and ischemic heart disease: The next therapeutic target?
2021, Revista Portuguesa de CardiologiaCitation Excerpt :While, as acknowledged by the authors, several issues should be considered when analyzing the present data, when taken together with the signal from the LoDoCo2 study these findings warrant further consideration and clarification prior to the possible generalization of colchicine treatment in this setting.21,22 In summary, the current evidence on colchicine reinforces its broad potential to reduce the risk of ischemic events in patients with IHD, with two large randomized trials showing a similar effect.19–21,94 Nevertheless, the findings from the LoDoCo2 and the Australian COPS trials in terms of non-CV mortality highlight the complexity of inflammatory modulation.21,22
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.