Claire X Y Goh1, Ying Kiat Tan1, Choon Han Tan2, Aloysius S T Leow3, Jamie S Y Ho4, Natalie H W Tan1, Sherill Goh1, Andrew F W Ho5, Vijay K Sharma1,3, Bernard P L Chan3, Leonard L L Yeo6,7, Benjamin Y Q Tan1,3. 1. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, Singapore. 2. Department of Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. 3. Division of Neurology, Department of Medicine, National University Health System, Singapore, Singapore. 4. Academic Foundation Programme, North Middlesex University Hospital NHS Trust, London, UK. 5. Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore. 6. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, Singapore. leonard_ll_yeo@nuhs.edu.sg. 7. Division of Neurology, Department of Medicine, National University Health System, Singapore, Singapore. leonard_ll_yeo@nuhs.edu.sg.
Abstract
OBJECTIVE: The primary objective is to evaluate the use of colchicine as an anti-inflammatory agent for stroke prevention in patients with coronary artery disease. BACKGROUND: There has been a rising number of randomized controlled trials conducted in patients with coronary artery disease on the use of colchicine in reducing cardiovascular complications. Recent publications suggest colchicine reduces the risk of stroke and other cardiovascular events. METHODS: We performed a systematic review of known trials in the current literature to characterize the clinical characteristics and outcomes of colchicine treatment in patients with coronary artery disease. A literature search was performed in PubMed, Embase and SCOPUS using a suitable keyword search strategy from inception to 4 June 2021. All studies evaluating cardiovascular outcomes of colchicine treatment in patients with coronary artery disease were included. RESULTS: The systemic review included 5 randomized controlled trials assessing a total of 11,790 patients. Majority of studies used a colchicine dosing regimen of 0.5 mg once daily, with the median follow-up duration ranging from 6 to 36 months. Meta-analytic estimates for stroke incidence highlighted a statistically significant benefit for patients that were administered colchicine compared to placebo (OR 0.47, 95% CI 0.27-0.81, p = 0.006), and a non-significant benefit for myocardial infarction. There was no significant association between colchicine treatment and the adverse effects of gastrointestinal symptoms and myopathy/myalgia. CONCLUSIONS: The use of colchicine reduces the risk of stroke in patients with a history of coronary artery disease, without a significant increase in gastrointestinal and myopathy/myalgia adverse effects.
OBJECTIVE: The primary objective is to evaluate the use of colchicine as an anti-inflammatory agent for stroke prevention in patients with coronary artery disease. BACKGROUND: There has been a rising number of randomized controlled trials conducted in patients with coronary artery disease on the use of colchicine in reducing cardiovascular complications. Recent publications suggest colchicine reduces the risk of stroke and other cardiovascular events. METHODS: We performed a systematic review of known trials in the current literature to characterize the clinical characteristics and outcomes of colchicine treatment in patients with coronary artery disease. A literature search was performed in PubMed, Embase and SCOPUS using a suitable keyword search strategy from inception to 4 June 2021. All studies evaluating cardiovascular outcomes of colchicine treatment in patients with coronary artery disease were included. RESULTS: The systemic review included 5 randomized controlled trials assessing a total of 11,790 patients. Majority of studies used a colchicine dosing regimen of 0.5 mg once daily, with the median follow-up duration ranging from 6 to 36 months. Meta-analytic estimates for stroke incidence highlighted a statistically significant benefit for patients that were administered colchicine compared to placebo (OR 0.47, 95% CI 0.27-0.81, p = 0.006), and a non-significant benefit for myocardial infarction. There was no significant association between colchicine treatment and the adverse effects of gastrointestinal symptoms and myopathy/myalgia. CONCLUSIONS: The use of colchicine reduces the risk of stroke in patients with a history of coronary artery disease, without a significant increase in gastrointestinal and myopathy/myalgia adverse effects.
Authors: Alberto Cecconi; Jean Paul Vilchez-Tschischke; Jesus Mateo; Javier Sanchez-Gonzalez; Samuel España; Rodrigo Fernandez-Jimenez; Beatriz Lopez-Melgar; Leticia Fernández Friera; Gonzalo J López-Martín; Valentin Fuster; Jesus Ruiz-Cabello; Borja Ibañez Journal: J Cardiovasc Transl Res Date: 2020-03-05 Impact factor: 4.132