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Meta-Analysis
. 2014 Nov-Dec;46(6):590-5.
doi: 10.4103/0253-7613.144905.

Colchicine in prevention of atrial fibrillation following cardiac surgery: systematic review and meta-analysis

Chintan Trivedi  1 , Mihir Sadadia  2
Affiliations
Meta-Analysis

Colchicine in prevention of atrial fibrillation following cardiac surgery: systematic review and meta-analysis

Chintan Trivedi et al. Indian J Pharmacol. 2014 Nov-Dec.

Abstract

Objectives: Inflammation is one of the predictors of atrial fibrillation (AF) following surgical or interventional cardiac procedures. Recent evidence suggests that colchicine may represent a new strategy to prevent AF following cardiac procedures. This study aims to assess the antiinflammatory efficacy of colchicine in prevention of early AF event (EAFE).

Materials and methods: We reviewed all available studies that assessed the effectiveness of colchicine therapy on the occurrence of AF in patients undergoing cardiac procedures. Meta-analysis was performed by random effect inverse variance-weighted method by entering AF events and the total population from each study.

Results: After thorough review of the databases, we found three studies comparing colchicine and placebo which had EAFE as the outcome. Of 584 patients, 286 patients were on colchicine and 298 on placebo. All the three studies were randomized. After pooled analysis, colchicine was associated with significant reduction in AF events compared to placebo (odds ratio = 0.44 [0.29, 0.66], P < 0.001). There was no statistical heterogeneity between included studies (χ(2) = 0.45, P = 0.80, I(2) = 0%).

Conclusion: Colchicine may prove beneficial in the prevention of AF following cardiac surgery. Further research is warranted.

Keywords: Atrial fibrillation; colchicine; early recurrence.

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Conflict of interest statement

Conflict of Interest: No.

Figures

Figure 1
Figure 1
Selection process of studies included in the systematic review (AF = Atrial fibrillation; PVAI = Pulmonary vein antrum isolation). Search Criteria: (“colchicine”[MeSH Terms] OR “colchicine”[All Fields]) AND (“atrial fibrillation”[MeSH Terms] OR (“atrial”[All Fields] AND “fibrillation”[All Fields]) OR “atrial fibrillation”[All Fields])
Figure 2
Figure 2
Forest plot showing the odds ratio of early atrial fibrillation associated with colchicine use in each study and the overall OR. Square boxes denote OR; horizontal lines represent 95% confidence interval
Figure 3
Figure 3
Funnel plot of the standard error of logarithm odds ratio against OR, displayed as OR. There is no presence of publication bias on visual estimation
Figure 4
Figure 4
Forest plot showing the odds ratio of atrial fibrillation associated with colchicine use in pulmonary vein antrum isolation study and the overall OR. Square boxes denote OR; horizontal lines represent 95% confidence interval
See this image and copyright information in PMC

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