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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Main Authors: Francesco Condello, Matteo Sturla, Bernhard Reimers, Gaetano Liccardo, Giulio G Stefanini, Gianluigi Condorelli, Giuseppe Ferrante
Format: Article
Language:English
Published: Radcliffe Medical Media 2021-10-01
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.
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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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