| Abstract: |
Background: Inflammation plays a key role in atherosclerotic plaque destabilization and adverse cardiac remodeling. Recent evidence has shown a promising role of colchicine in patients with coronary artery disease. We evaluated the efficacy and safety of colchicine in post-acute myocardial infarction (MI) patients. Methods: We searched five electronic databases from inception to January 18, 2021, for randomized controlled trials (RCTs) evaluating colchicine in post-acute MI patients. Primary outcomes were cardiovascular mortality and recurrent MI. Secondary outcomes were all-cause mortality, stroke, urgent coronary revascularization, levels of follow-up high-sensitivity C-reactive protein (hs-CRP), and drug-related adverse events. All meta-analyses used inverse-variance random-effects models. Results: Six RCTs involving 6,005 patients were included. Colchicine did not significantly reduce cardiovascular mortality [risk ratio (RR), 0. 91; 95% confidence interval (95% CI), 0. 52-1. 61; p = 0. 64], recurrent MI (RR, 0. 87; 95% CI, 0. 62-1. 22; p = 0. 28), all-cause mortality (RR, 1. 06; 95% CI, 0. 61-1. 85; p = 0. 78), stroke (RR, 0. 28; 95% CI, 0. 07-1. 09; p = 0. 05), urgent coronary revascularization (RR, 0. 46; 95% CI, 0. 02-8. 89; p = 0. 19), or decreased levels of follow-up hs-CRP (mean difference, −1. 95 mg/L; 95% CI, −12. 88 to 8. 98; p = 0. 61) compared to the control group. There was no increase in any adverse events (RR, 0. 97; 95% CI, 0. 89-1. 07; p = 0. 34) or gastrointestinal adverse events (RR, 2. 49; 95% CI, 0. 48-12. 99; p = 0. 20). Subgroup analyses by colchicine dose (0. 5 vs. 1 mg/day), time of follow-up (<1 vs. ≥1 year), and treatment duration (≤30 vs. >30 days) showed no changes in the overall findings. Conclusion: In post-acute MI patients, colchicine does not reduce cardiovascular or all-cause mortality, recurrent MI, or other cardiovascular outcomes. Also, colchicine did not increase drug-related adverse events. |
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