Masson Walter, Lobo Martín, Molinero Graciela, Masson Gerardo, Lavalle-Cobo Augusto
Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Buenos Aires, Argentina.
Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Buenos Aires, Argentina.
J Stroke Cerebrovasc Dis. 2020 May;29(5):104756. doi: 10.1016/j.jstrokecerebrovasdis.2020.104756. Epub 2020 Mar 9.
Colchicine is a microtubule inhibitor with anti-inflammatory properties. As the body and quality of evidence regarding the efficacy of colchicine for cardiovascular prevention is controversial, the aims of this study was to evaluate the effect of colchicine therapy on vascular events.
A meta-analysis was performed of randomized controlled clinical trials of colchicine on high cardiovascular risk populations, reporting data from stroke, myocardial infarction, cardiovascular mortality and all-cause mortality, after searching the PubMed/MEDLINE, Embase and Cochrane Controlled Trials databases. A random-effects meta-analysis model was then applied.
Nine eligible trials of colchicine therapy, involving a total of 6630 patients, were considered eligible for analysis (3359 subjects were allocated to receive colchicine while 3271 subjects were allocated to the respective control arms). The stroke incidence was lower in the colchicine group compared with placebo arm (OR, .33; 95%CI, .15-.70; 6 studies evaluated). We did not find a significant reduction in the incidence of myocardial infarction, cardiovascular mortality or all-cause mortality.
Our data suggest that in a population with high cardiovascular risk, the use of colchicine results in significant reduction on stroke risk. Colchicine is an accessible drug that could be successfully utilized for the prevention of atherosclerotic cerebrovascular disease. The tolerability and benefits should be confirmed in ongoing clinical trials.
秋水仙碱是一种具有抗炎特性的微管抑制剂。由于关于秋水仙碱在心血管预防方面疗效的证据主体和质量存在争议，本研究旨在评估秋水仙碱治疗对血管事件的影响。
在检索了PubMed/MEDLINE、Embase和Cochrane对照试验数据库后，对秋水仙碱用于心血管高危人群的随机对照临床试验进行了荟萃分析，报告中风、心肌梗死、心血管死亡率和全因死亡率的数据。然后应用随机效应荟萃分析模型。
九项关于秋水仙碱治疗的合格试验，共涉及6630名患者，被认为符合分析条件（3359名受试者被分配接受秋水仙碱治疗，而3271名受试者被分配到各自的对照组）。与安慰剂组相比，秋水仙碱组的中风发生率较低（比值比，0.33；95%置信区间，0.15 - 0.70；6项研究进行了评估）。我们未发现心肌梗死、心血管死亡率或全因死亡率有显著降低。
我们的数据表明，在心血管高危人群中，使用秋水仙碱可显著降低中风风险。秋水仙碱是一种可获取的药物，可成功用于预防动脉粥样硬化性脑血管疾病。其耐受性和益处应在正在进行的临床试验中得到证实。
