Oxford University Hospitals NHS Trust, Oxford, UK
Wycombe Hospital Department of Cardiology, Buckinghamshire Healthcare NHS Trust, High Wycombe, UK.
Open Heart. 2022 Jan;9(1). doi: 10.1136/openhrt-2021-001887.
Percutaneous coronary intervention (PCI), the preferred coronary reperfusion strategy, induces endothelial trauma which may mount an inflammatory response. This has been shown to increase the likelihood of further major adverse cardiovascular events (MACE). Colchicine, a cheap and widely used anti-inflammatory has shown promise in improving cardiovascular outcomes. We aimed to perform a systematic review and meta-analysis to study the effects of colchicine in patients with symptomatic coronary artery disease (CAD) who have undergone PCI.
We systematically reviewed and meta-analysed 7 randomised controlled trials including a total of 6660 patients (colchicine group: 3347, control group: 3313; mean age=60.9±10). Six studies included participants who had a ≤13.5-day history of acute coronary syndrome (ACS). One study included patients with both ACS and chronic coronary syndrome. The follow-up of studies ranged from 3 days to 22.6 months.
The use of colchicine in patients who underwent PCI significantly reduced MACE outcomes (risk ratio 0.73 (95% CI 0.61 to 0.87); p=0.0003) with minimal heterogeneity across the analysis (I=6%; P for Cochran Q=0.38). These results were driven mainly by the reduction in repeat vessel revascularisation, stroke and stent thrombosis. The number needed to treat to prevent one occurrence of MACE was 41.
Colchicine significantly reduced the risk of MACE in patients with CAD who underwent PCI, mostly in the reduction of repeat vessel revascularisation, stroke and stent thrombosis. The efficacy of colchicine should be further studied by distinguishing its use alongside different stent types and dosing regimens.
CRD42021245699.
经皮冠状动脉介入治疗（PCI）是首选的冠状动脉再灌注策略，会引起内皮创伤，从而引发炎症反应。这增加了发生进一步主要不良心血管事件（MACE）的可能性。秋水仙碱是一种廉价且广泛使用的抗炎药，已显示出改善心血管结局的潜力。我们旨在进行系统评价和荟萃分析，以研究在接受 PCI 的有症状冠状动脉疾病（CAD）患者中使用秋水仙碱的效果。
我们系统地回顾和荟萃分析了 7 项随机对照试验，共纳入 6660 名患者（秋水仙碱组：3347 名，对照组：3313 名；平均年龄=60.9±10）。6 项研究纳入了急性冠状动脉综合征（ACS）病史≤13.5 天的患者。一项研究纳入了 ACS 和慢性冠状动脉综合征的患者。研究的随访时间从 3 天到 22.6 个月不等。
在接受 PCI 的患者中使用秋水仙碱可显著降低 MACE 结局（风险比 0.73（95%CI 0.61 至 0.87）；p=0.0003），分析过程中的异质性很小（I=6%；P 值为 Cochran Q=0.38）。这些结果主要是通过减少重复血管血运重建、中风和支架血栓形成来实现的。预防一次 MACE 发生的所需治疗人数为 41。
秋水仙碱可显著降低接受 PCI 的 CAD 患者的 MACE 风险，主要是通过减少重复血管血运重建、中风和支架血栓形成来实现的。应进一步研究秋水仙碱的疗效，区分其与不同支架类型和剂量方案的使用。
PROSPERO 注册号：CRD42021245699。
