Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis

Objectives: To evaluate the efficacy and safety of colchicine in preventing adverse cardiovascular outcomes in adults with coronary artery disease (CAD). Methodology: This systematic review and meta-analysis were conducted by searching PubMed, Scopus, and the Cochrane Library databases. Randomized controlled trials (RCTs) assessing the effects of colchicine on cardiac mortality, cardiac injury, or adverse events in adults aged 18 years and older with CAD were included. Data extraction and risk of bias assessment were independently performed by two reviewers. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for dichotomous outcomes, and mean differences (MD) for continuous outcomes. A random-effects model was applied to synthesize data. Results: Seven RCTs met the inclusion criteria and were analyzed. Colchicine treatment was associated with a statistically significant reduction in cardiovascular mortality (OR = 0.75; 95% CI, 0.60–0.92; p=0.007). However, the effects on cardiac injury markers were not statistically significant and demonstrated high heterogeneity. Safety outcomes also showed no significant difference overall but revealed variability across studies. Some trials reported increased incidences of gastrointestinal adverse effects, as well as elevations in liver enzymes (alanine aminotransferase) and muscle injury markers (creatine kinase), indicating potential hepatic and muscular side effects. Conclusion: Colchicine shows potential in significantly reducing cardiovascular mortality in adults with CAD. Nevertheless, its impact on cardiac injury and safety profiles remains inconclusive, highlighting the need for further standardized, high-quality trials to inform clinical practice.