Association of Perioperative Colchicine Use with Morbidity and Inflammation in Heart Valve Surgery

Background and Objectives: Valvular heart disease (VHD) is a major cause of morbidity and mortality worldwide, and valve replacement surgery performed under cardiopulmonary bypass (CPB) with full sternotomy remains an important treatment modality. Colchicine has well-established anti-inflammatory effects in ischemic heart disease and pericardial disease, but its association with postoperative morbidity in patients undergoing valvular heart surgery has not been well studied. This study aimed to investigate the association of perioperative colchicine use with clinical morbidity and inflammatory parameters in patients undergoing valvular heart surgery with CPB. Materials and Methods: In this retrospective study, 82 patients who underwent elective on-pump valvular heart surgery through full sternotomy were divided into a control group (n = 42) who did not receive colchicine and a colchicine group (n = 40) who received oral colchicine (0.5 mg once daily) for three days before and ten days after surgery. Demographic, clinical, and laboratory data, including length of hospital and intensive care unit (ICU) stay, transfusion requirements, sternal wound complication, surgical re-exploration, and inflammatory parameters on postoperative day 5 (C-reactive protein [CRP], white blood cell count, albumin, platelet-to-lymphocyte ratio [PLR], and neutrophil-to-lymphocyte ratio [NLR]), were compared between the groups. Results: Length of ICU stay was significantly shorter in the colchicine group than in the control group (4.1 ± 1.6 vs. 5.3 ± 2.4 days; p = 0.009), and fresh frozen plasma transfusion requirement was significantly lower in the colchicine group (4.2 ± 2.1 vs. 6.9 ± 3.3 units; p < 0.001). Total hospital stay, erythrocyte transfusion requirement, and inflammatory parameters (CRP, white blood cell count, NLR, PLR, and albumin) did not differ significantly between the two groups (all p > 0.05). Conclusions: Perioperative colchicine was associated with a shorter ICU stay and a reduced requirement for fresh frozen plasma transfusion in patients undergoing valvular heart surgery with CPB, suggesting that colchicine may have a potential role in this surgical population. After correction for multiple comparisons, the difference in ICU length of stay was no longer statistically significant. Larger prospective studies are warranted to confirm these findings.