Colchicine for Patients With Coronary Artery Disease: A Systematic Review and Meta-analysis. Issue 4 (April 2022)

• Record Type: Journal Article
• Authors: Shrestha, Dhan B.; Budhathoki, Pravash; Sedhai, YubRaj; Khadka, Manoj; Pokharel, Subashchandra; Yadav, Stuti; Patel, Toralben; Elgendy, Islam; Mir, Wasey Ali Yadullahi; Patel, Nimesh K.
• Is Part Of: Journal of cardiovascular pharmacology. Volume 79:Issue 4(2022)
• Page Start: 420
• Page End: 430
• Publication Date: 2022-04
• Subjects: coronary artery disease -- colchicine -- cytokines -- myocardial infarction -- anti-inflammatory agents; Cardiovascular Diseases -- drug therapy -- Periodicals; Cardiovascular System -- drug effects -- Periodicals; Cardiovascular pharmacology -- Periodicals; Cardiovascular agents -- Periodicals; Cardiovascular agents; Cardiovascular pharmacology; Periodicals; 615.7105
• DOI: 10.1097/FJC.0000000000001200
• Languages: English
• ISSNs: 0160-2446

Abstract

Abstract : Supplemental Digital Content is Available in the Text. Abstract: Several randomized controlled trials have studied the role of colchicine, a potent anti-inflammatory drug, to prevent adverse cardiovascular events in patients with coronary artery disease (CAD). In this meta-analysis, we aimed to determine the role of colchicine in patients with CAD in clinical outcomes and mortality. We searched PubMed, PubMed Central, Scopus, and Embase for randomized controlled trials/experimental studies evaluating the role of colchicine in patients with CAD. After assessing the eligibility for inclusion, risk-of-bias assessment, and data extraction from the included studies, a narrative synthesis was conducted. Of 17 studies included for the qualitative analysis, 11 studies reported that inflammatory markers such as C-reactive protein and cytokines were reduced in the colchicine group, suggesting an anti-inflammatory role of colchicine in CAD. Quantitative analysis with pooling of data from 9 studies using a fixed-effect model showed 28% lower odds of acute myocardial infarction [odds ratio (OR) 0.72, 95% CI 0.59–0.86; n = 11, 712], 52% lower occurrence of stroke (OR 0.48, 95% CI 0.30–0.76), and 37% reduction in odds of coronary revascularization procedure in the colchicine group (OR 0.63, 95% CI 0.52–0.76; n= 11, 258). However, the odds of gastrointestinal adverse events were 50% higher in the colchicine group (OR 1.50, 95% CI 1.01–2.23; n = 12, 214). In conclusion, colchicine is associated with a lower risk of acute myocardial infarction, stroke, and coronary revascularization. However, there is some increased risk of gastrointestinal adverse events with the use of colchicine.