Colchicine in patients with coronary disease undergoing coronary artery bypass surgery: a meta-analysis of randomized controlled trials

Abstract Background Recent randomized evidence has shown that low dose colchicine lowers the risk of cardiovascular events in patients with chronic coronary artery disease (CAD). Colchicine has also been used in coronary artery bypass grafting (CABG) with individual studies suggesting protective effects for postoperative atrial fibrillation (POAF). We performed a meta-analysis of studies assessing the effect of colchicine on outcomes in CABG surgery. Purpose To determine the potential of colchicine for reducing post-operative atrial fibrillation or other adverse events in patients undergoing CABG. Methods We systematically searched three libraries (MEDLINE, Web of Science and The Cochrane Library) selecting all randomized control trials (RCT) including patients who underwent CABG and were randomized for pre- or perioperative administration of colchicine versus standard of care. Primary outcome was incidence of POAF. Inverse variance method (DerSimonian&Laird) and random effects model were performed. The leave-one-out analysis was carried out as a sensitivity analysis to address possible outliers. Results From 205 screened studies, five met the inclusion criteria and were selected. The data from 839 patients were included in the final analysis. Included studies were published between 2014 and 2022. The perioperative administration of colchicine was associated with reduction of POAF rates after CABG when compared to standard of care (relative risk; RR= 0.54, 95% confidence interval; CI, 0.40-0.73, p<0.01 – Fig. 1). The leave-one-out analysis confirmed the robustness of the analysis, with minimal variations of the confidence interval (Fig. 2). Conclusions This meta-analysis of randomized studies suggests that the perioperative administration of colchicine is associated with significant reduction of POAF rates after CABG.Forest plotLeave-one-out analysis