Colchicine in Patients With Coronary Artery Disease: A Systematic Review and Meta‐Analysis of Randomized Trials

BACKGROUND: Inflammation plays a pivotal role in coronary artery disease (CAD). The anti- inflammatory drug colchicine seems to reduce ischemic events in patients with CAD. So far there is equipoise about its safety and impact on mortality METHODS AND RESULTS: To evaluate the utility of colchicine in patients with acute and chronic CAD, we performed a systematic review and meta- analysis. MEDLINE, EMBASE, Cochrane CENTRAL and conference abstracts were searched from January 1975 to October 2020. Randomized trials assessing colchicine compared with placebo/standard therapy in patients with CAD were included. Data were combined using random- effects models. The reliability of the available data was tested using trial sequential analyses. Of 3108 citations, 13 randomized trials (n=13 125) were included. Colchicine versus placebo/standard therapy in patients withCAD reduced risk of myocardial infarction (odds ratio [OR] 0.64; 95% CI, 0.46 – 0.90; P= 0.01; I 41%) and stroke/transient ischemic attack (OR 0.50; 95% CI, 0.31– 0.81; P=0.005; I 0%). But treatment with colchicine compared with placebo/standard therapy had no influence on all- cause and cardiovascular mortality (OR 0.96; 95% CI, 0.65– 1.41; P=0.83; I 24%; and OR 0.82; 95% CI, 0.55– 1.22; P=0.45; I 0%, respectively). Colchicine increased the risk for gastrointestinal side effects (P<0.001). According to trial sequential analyses, there is only sufficient evidence for a myocardial infarction risk reduction with colchicine. CONCLUSIONS: Among patients with CAD, colchicine reduces the risk of myocardial infarction and stroke, but has a higher rate of gastrointestinal upset with no influence on all- cause mortality.
+ ID der Publikation: unilu_54969 + Sprache: Englisch + Letzte Aktualisierung: 2021-10-27 16:06:46