Association Between Colchicine Treatment and Clinical Outcomes in Patients with Coronary Artery Disease: Systematic Review and Meta-analysis
Background: The authors examined the association between colchicine treatment and clinical outcomes in patients with coronary artery disease. Methods: They performed a meta-analysis of randomised controlled trials (RCTs) involving patients with coronary artery disease receiving add-on colchicine to...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2021-10-01
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| Series: | European Cardiology Review |
| Online Access: | https://www.ecrjournal.com/articleindex/ecr.2021.31 |
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| author | Francesco Condello Matteo Sturla Bernhard Reimers Gaetano Liccardo Giulio G Stefanini Gianluigi Condorelli Giuseppe Ferrante |
| author_facet | Francesco Condello Matteo Sturla Bernhard Reimers Gaetano Liccardo Giulio G Stefanini Gianluigi Condorelli Giuseppe Ferrante |
| author_sort | Francesco Condello |
| collection | DOAJ |
| description | Background: The authors examined the association between colchicine treatment and clinical outcomes in patients with coronary artery disease. Methods: They performed a meta-analysis of randomised controlled trials (RCTs) involving patients with coronary artery disease receiving add-on colchicine to standard treatment compared with standard treatment. They used a mixed-effects Poisson regression model with random intervention effects to estimate the pooled incidence rate ratios (IRR) with 95% CI. Results: Ten RCTs were identified, including 12,819 participants followed up for a median of 6 months. Colchicine was associated with a lower risk of major adverse cardiovascular events (IRR 0.69; 95% CI [0.60–0.79]; number needed to treat for an additional beneficial outcome [NNTB] = 28); MI (IRR 0.77; 95% CI [0.64–0.93]; NNTB = 95) and ischaemic stroke (IRR 0.48; 95% CI [0.30–0.76]; NNTB = 155) and with a higher risk of gastrointestinal adverse events (IRR 1.69; 95% CI [1.12–2.54]; number needed to treat for an additional harmful outcome [NNTH] = 10). Colchicine did not affect all-cause death (IRR 1.09; 95% CI [0.85–1.40]), or cardiovascular death (IRR 0.75; 95% CI [0.51–1.12]), while it was associated with a higher risk of non-cardiovascular death (IRR 1.45; 95% CI [1.04–2.02]; NNTH = 396). Conclusion: The meta-analysis showed that the relative and absolute beneficial treatment effects of colchicine on cardiovascular outcomes outweigh the potential harm for non-cardiovascular mortality. Registration: PROSPERO 2021 CRD42021248874. |
| format | Article |
| id | doaj-art-e850f9fdd86a4034972f80375d188bd5 |
| institution | OA Journals |
| issn | 1758-3756 1758-3764 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | European Cardiology Review |
| spelling | doaj-art-e850f9fdd86a4034972f80375d188bd52025-08-20T02:37:51ZengRadcliffe Medical MediaEuropean Cardiology Review1758-37561758-37642021-10-011610.15420/ecr.2021.31Association Between Colchicine Treatment and Clinical Outcomes in Patients with Coronary Artery Disease: Systematic Review and Meta-analysisFrancesco Condello0Matteo Sturla1Bernhard Reimers2Gaetano Liccardo3Giulio G Stefanini4Gianluigi Condorelli5Giuseppe Ferrante6Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; Department of Cardiovascular Medicine, Humanitas Research Hospital, IRCCS, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; Department of Cardiovascular Medicine, Humanitas Research Hospital, IRCCS, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; Department of Cardiovascular Medicine, Humanitas Research Hospital, IRCCS, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; Department of Cardiovascular Medicine, Humanitas Research Hospital, IRCCS, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; Department of Cardiovascular Medicine, Humanitas Research Hospital, IRCCS, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; Department of Cardiovascular Medicine, Humanitas Research Hospital, IRCCS, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; Department of Cardiovascular Medicine, Humanitas Research Hospital, IRCCS, Rozzano, Milan, ItalyBackground: The authors examined the association between colchicine treatment and clinical outcomes in patients with coronary artery disease. Methods: They performed a meta-analysis of randomised controlled trials (RCTs) involving patients with coronary artery disease receiving add-on colchicine to standard treatment compared with standard treatment. They used a mixed-effects Poisson regression model with random intervention effects to estimate the pooled incidence rate ratios (IRR) with 95% CI. Results: Ten RCTs were identified, including 12,819 participants followed up for a median of 6 months. Colchicine was associated with a lower risk of major adverse cardiovascular events (IRR 0.69; 95% CI [0.60–0.79]; number needed to treat for an additional beneficial outcome [NNTB] = 28); MI (IRR 0.77; 95% CI [0.64–0.93]; NNTB = 95) and ischaemic stroke (IRR 0.48; 95% CI [0.30–0.76]; NNTB = 155) and with a higher risk of gastrointestinal adverse events (IRR 1.69; 95% CI [1.12–2.54]; number needed to treat for an additional harmful outcome [NNTH] = 10). Colchicine did not affect all-cause death (IRR 1.09; 95% CI [0.85–1.40]), or cardiovascular death (IRR 0.75; 95% CI [0.51–1.12]), while it was associated with a higher risk of non-cardiovascular death (IRR 1.45; 95% CI [1.04–2.02]; NNTH = 396). Conclusion: The meta-analysis showed that the relative and absolute beneficial treatment effects of colchicine on cardiovascular outcomes outweigh the potential harm for non-cardiovascular mortality. Registration: PROSPERO 2021 CRD42021248874.https://www.ecrjournal.com/articleindex/ecr.2021.31 |
| spellingShingle | Francesco Condello Matteo Sturla Bernhard Reimers Gaetano Liccardo Giulio G Stefanini Gianluigi Condorelli Giuseppe Ferrante Association Between Colchicine Treatment and Clinical Outcomes in Patients with Coronary Artery Disease: Systematic Review and Meta-analysis European Cardiology Review |
| title | Association Between Colchicine Treatment and Clinical Outcomes in Patients with Coronary Artery Disease: Systematic Review and Meta-analysis |
| title_full | Association Between Colchicine Treatment and Clinical Outcomes in Patients with Coronary Artery Disease: Systematic Review and Meta-analysis |
| title_fullStr | Association Between Colchicine Treatment and Clinical Outcomes in Patients with Coronary Artery Disease: Systematic Review and Meta-analysis |
| title_full_unstemmed | Association Between Colchicine Treatment and Clinical Outcomes in Patients with Coronary Artery Disease: Systematic Review and Meta-analysis |
| title_short | Association Between Colchicine Treatment and Clinical Outcomes in Patients with Coronary Artery Disease: Systematic Review and Meta-analysis |
| title_sort | association between colchicine treatment and clinical outcomes in patients with coronary artery disease systematic review and meta analysis |
| url | https://www.ecrjournal.com/articleindex/ecr.2021.31 |
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