Background
Colchicine has become prominent as an anti-inflammatory therapy for secondary cardiovascular
prevention in patients with coronary artery disease (CAD). This meta-analysis was
performed to evaluate the efficacy and safety of colchicine in patients with CAD.
Methods
Randomised controlled trials (RCTs) that compare major adverse cardiovascular events
(MACEs) between patients with CAD randomised to colchicine versus placebo (or no colchicine)
were included. Random effect risk ratios (RRs) were calculated for clinical outcomes.
Results
A total of 12,071 patients in seven RCTs were included in the meta-analysis. Compared
with placebo or no colchicine, colchicine was associated with a significantly lower
incidence of MACEs (RR 0.64, 95% CI 0.51–0.80, p<0.01). The reduction in MACEs in
the colchicine group was driven by statistically significant reductions in the incidence
of myocardial ischaemia (RR 0.74, 95% CI 0.58–0.95, p=0.02), coronary revascularisation
(RR 0.61, 95% CI 0.42–0.89, p=0.01), and stroke (RR 0.48, 95% CI 0.28–0.83, p=0.01).
However, there was no statistically significant difference for cardiovascular death
(RR 0.82, 95% CI 0.55–1.22, p=0.33). All-cause and non-cardiovascular mortality, gastrointestinal
events, infection, and cancer were not significantly different between the colchicine
and control groups.
Conclusions
Colchicine is a reasonably efficacious and safe drug that could be successfully utilised
for the secondary prevention of CAD.
Keywords
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Article info
Publication history
Published online: January 12, 2022
Accepted:
September 12,
2021
Received in revised form:
June 6,
2021
Received:
February 28,
2021
Identification
Copyright
© 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
