Evaluating the risk of atrial fibrillation in patients with chronic recurrent pericarditis prescribed colchicine: Observations using TriNetX global federated research network

Chronic pericarditis is associated with significant cardiovascular morbidity, including atrial fibrillation (AF), heart failure (HF), and stroke. Colchicine is widely used in pericarditis management for its anti-inflammatory effects, but its impact on arrhythmias and other cardiovascular outcomes remains uncertain. We conducted a retrospective observational cohort study using the TriNetX global federated research network to assess the association between colchicine use and cardiovascular outcomes in in-patients with chronic pericarditis. Patients diagnosed with chronic adhesive and constrictive pericarditis with or without colchicine use between 2010 and 2024 were included. Propensity score matching (PSM) (1:1) was used to balance baseline characteristics. The primary outcome was 1-year incidence of AF. Secondary outcomes included all-cause mortality, ischemic stroke, acute myocardial infarction (AMI), acute HF, cardiac arrest, ventricular arrhythmias, and a composite cardiovascular outcome. Of 8,120 patients hospitalized with chronic pericarditis, 1,064 received colchicine. 1,061 patients were matched in each group after PSM. The 1-year incidence of AF was similar between colchicine users and non-users (HR: 0.90, 95% CI: 0.76–1.06) after PSM. Colchicine use was associated with significantly lower risk of all-cause mortality (HR: 0.67, 95% CI: 0.54–0.84) and ischemic stroke (HR: 0.45, 95% CI: 0.29–0.67) after PSM. No significant differences were observed for AMI, cardiac arrest, HF, or ventricular arrhythmias. In this real-world cohort of patients with chronic pericarditis, colchicine did not increase the risk of AF. Colchicine was linked to significantly lower risks of all-cause mortality and ischemic stroke in hospitalized chronic pericarditis patients, suggesting potential systemic cardiovascular benefits.