Colchicine for Coronary Heart Disease: A Meta-Analysis of Randomized Controlled Trials

Authors

  • Chunfeng Liao Department of Cardiology, The First Hospital Of Changsha, Hunan Province, China
  • Ping Liu Department of Respiratory and Critical Care Medicine, The First Hospital Of Changsha, Hunan Province, China
  • Yun Zhou Department of Orthopedics, The First Hospital Of Changsha, Hunan Province, China
  • Di Lu Department of Ultrasound, Dianjiang County Hospital of Traditional Chinese Medicine, Chongqing
  • Qi Wu Department of Critical Care Medicine, The First Hospital Of Changsha, Hunan Province, China

DOI:

https://doi.org/10.1532/hsf.3609

Keywords:

colchicine, myocardial infarction, percutaneous coronary intervention (PCI), randomized controlled trials

Abstract

Background: The efficacy of colchicine administration for coronary heart disease remains controversial. We conducted a systematic review and meta-analysis to explore the influence of colchicine administration versus placebo on treatment efficacy for coronary heart disease.

Methods: We have searched PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases through May 2021 for randomized controlled trials (RCTs) assessing the effect of colchicine administration versus placebo in patients with coronary heart disease. This meta-analysis was performed using the random-effects model.

Results: Six RCTs involving 6,321 patients were included in the meta-analysis. Overall, compared with control groups for coronary heart disease, colchicine intervention can significantly reduce major adverse cardiovascular events (odds ratio [OR] 0.74; 95% confidence interval [CI] 0.59 to 0.92; P = .006), but revealed no obvious impact on mortality (OR=0.93; 95% CI=0.63 to 1.36; P = .69), serious adverse events (OR 0.71; 95% CI 0.31 to 1.61; P = .41), or restenosis (OR 1.02; 95% CI 0.63 to 1.64; P = .95).

Conclusions: Colchicine treatment may be effective to reduce major adverse cardiovascular events in patients with coronary heart disease.

References

Aggarwal A, Schneider DJ, Terrien EF, Gilbert KE, Dauerman HL. Increase in interleukin-6 in the first hour after coronary stenting: An early marker of the inflammatory response. J Thrombosis Thrombolysis 2003;15:25-31.

Akodad M, Lattuca B, Nagot N, et al. COLIN trial: Value of colchicine in the treatment of patients with acute myocardial infarction and inflammatory response. Arch Cardiovasc Dis 2017;110:395-402.

Borden WB, Redberg RF, Mushlin AI, et al. Patterns and intensity of medical therapy in patients undergoing percutaneous coronary intervention. JAMA 2011;305:1882-1889.

Briguori C, Visconti G, Focaccio A, et al. Novel approaches for preventing or limiting events (Naples) II trial: impact of a single high loading dose of atorvastatin on periprocedural myocardial infarction. J Am Coll Cardiol 2009;54:2157-2163.

Cao B, Zhang C, Wang H, Xia M, Yang X. Renoprotective effect of remote ischemic postconditioning in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Ther Clin Risk Manage 2018;14:369-375.

Echouffo-Tcheugui JB, Kolte D, Khera S, et al. Diabetes mellitus and cardiogenic shock complicating acute myocardial infarction. Am J Med 2018;131:778-786.

Guo L, Zhong L, Chen K, Wu J, Huang RC. Long-term clinical outcomes of optimal medical therapy vs. successful percutaneous coronary intervention for patients with coronary chronic total occlusions. Hellenic J Cardiol 2018;59:281-287.

Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 21 2002;1539-1558.

Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Controlled Clin Trials 1996;17:1-12.

Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: A quantitative review of 23 randomised trials. Lancet 2003;361:13-20.

Kjaergard LL, Villumsen J, Gluud C. Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 2001;135:982-989.

Martinon F, Pétrilli V, Mayor A, Tardivel A, Tschopp J. Gout-associated uric acid crystals activate the NALP3 inflammasome. Nature 2006;440:237-241.

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. J Clin Epidemiol 2009;62:1006-1012.

Nidorf M, Thompson PL. Effect of colchicine (0.5 mg twice daily) on high-sensitivity C-reactive protein independent of aspirin and atorvastatin in patients with stable coronary artery disease. Am J Cardiol 2007;99:805-807.

Novack V, Pencina M, Cohen DJ, et al. Troponin criteria for myocardial infarction after percutaneous coronary intervention. Arch Intern Med 2012;172:502-508.

O'Keefe JH Jr, McCallister BD, Bateman TM, et al. Ineffectiveness of colchicine for the prevention of restenosis after coronary angioplasty. J Am Coll Cardiol 1992;19:1597-1600.

Ottani F, Limbruno U, Latini R, Misuraca L, Galvani M. Reperfusion in STEMI patients: Still a role for cardioprotection? Minerva Cardioangiol 2018;66:452-463.

Pasceri V, Patti G, Nusca A, et al. Randomized trial of atorvastatin for reduction of myocardial damage during coronary intervention: Results from the ARMYDA (Atorvastatin for Reduction of Myocardial Damage during Angioplasty) study. Circulation 2004;110:674-678.

Paschke S, Weidner AF, Paust T, et al. Technical advance: Inhibition of neutrophil chemotaxis by colchicine is modulated through viscoelastic properties of subcellular compartments. J Leukocyte Biol 2013;94:1091-1096.

Patti G, Pasceri V, Colonna G, et al. Atorvastatin pretreatment improves outcomes in patients with acute coronary syndromes undergoing early percutaneous coronary intervention: Results of the ARMYDA-ACS randomized trial. J Am Coll Cardiol 2007;49:1272-1278.

Ridker PM, Everett BM, Thuren T, et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med 2017;377:1119-1131.

Russo JJ, Bagai A, Le May MR, Yan AT. Immediate non-culprit vessel percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and cardiogenic shock: A swinging pendulum. J Thorac Dis 2018;10:661-666.

Shah B, Allen N, Harchandani B, et al. Effect of colchicine on platelet-platelet and platelet-leukocyte interactions: A pilot study in healthy subjects. Inflammation 2016;39:182-189.

Shah B, Pillinger M, Zhong H, et al. Effects of acute colchicine administration prior to percutaneous coronary intervention: COLCHICINE-PCI randomized trial. Circul Cardiovasc Intervent 2020;13:e008717.

Shu J, Ren N, Du JB, et al. Increased levels of interleukin-6 and matrix metalloproteinase-9 are of cardiac origin in acute coronary syndrome. Scandinavian Cardiovasc J 2007;41:149-154.

Silva MA, Swanson AC, Gandhi PJ, Tataronis GR. Statin-related adverse events: A meta-analysis. Clin Ther 2006;28:26-35.

Tardif JC, Kouz S, Waters DD, et al. Efficacy and safety of low-dose colchicine after myocardial infarction. N Engl J Med 2019;381:2497-2505.

Terkeltaub RA, Furst DE, Bennett K, et al. High versus low dosing of oral colchicine for early acute gout flare: Twenty-four-hour outcome of the first multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-comparison colchicine study. Arthritis Rheumatism 2010;62:1060-1068.

Tong DC, Quinn S, Nasis A, et al. Colchicine in patients with acute coronary syndrome: The Australian COPS randomized clinical trial. Circulation 2020;142:1890-1900.

Yang HT, Xiu WJ, Zheng YY, et al. Invasive reperfusion after 12 hours of the symptom onset remains beneficial in patients with ST-segment elevation myocardial infarction: Evidence from a meta-analysis of published data. Cardiol J 2019;26:333-342.

Zarpelon CS, Netto MC, Jorge JC, et al. Colchicine to reduce atrial fibrillation in the postoperative period of myocardial revascularization. Arq Bras Cardiol 2016;107:4-9.

Published

2021-10-07

How to Cite

Liao, C., Liu, P., Zhou, Y., Lu, D., & Wu, Q. (2021). Colchicine for Coronary Heart Disease: A Meta-Analysis of Randomized Controlled Trials. The Heart Surgery Forum, 24(5), E863-E867. https://doi.org/10.1532/hsf.3609

Issue

Section

Articles