Department of Cardiology, First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 40000, China.
Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 40000, China.
J Cardiothorac Surg. 2022 Sep 1;17(1):224. doi: 10.1186/s13019-022-01958-9.
Postoperative atrial fibrillation (POAF) is the most common complication after cardiothoracic surgery or cardiac intervention. Colchicine is an anti-inflammatory agent that was associated with improved cardiovascular outcomes. However, its effect on POAF prevention was inconsistent across studies. Therefore, the aim of this meta-analysis was to evaluate the efficacy of colchicine in prevention of POAF.
We searched PubMed, Embase, ClinicalTrials.gov, Cochrane Library database and Google Scholar for randomized controlled trials (RCTs), using terms "atrial fibrillation" and "colchicine". The primary end point was the occurrence of clinically diagnosed atrial fibrillation. The relative risk (RR) and 95% confidence interval (CI) were evaluated. Estimates were pooled using DerSimonian-Laird random-effects model. We also performed subgroup analyses based on the duration and dose of colchicine treatment.
A total of 9 RCTs were included in this meta-analysis, enrolling a total of 2031 patients. Colchicine significantly reduces the incidence of POAF (RR 0.62; 95% CI, 0.52-0.74, P < 0.001, I = 0%). Subgroup analyses indicated that the protective effect of colchicine on POAF was slightly stronger in the long-duration group (RR 0.60; 95% CI, 0.48-0.75, P < 0.001, I = 0%) than in the short-duration group (RR 0.65; 95% CI, 0.49-0.86, P < 0.001, I = 0%).
Colchicine is effective in preventing the occurrence of POAF. The efficacy of colchicine can be slightly increased over treatment duration, with no obvious adverse reactions.
术后心房颤动（POAF）是心胸外科或心脏介入术后最常见的并发症。秋水仙碱是一种抗炎药，与改善心血管结局有关。然而，其在预防 POAF 方面的效果在不同的研究中并不一致。因此，本荟萃分析旨在评估秋水仙碱预防 POAF 的疗效。
我们检索了 PubMed、Embase、ClinicalTrials.gov、Cochrane 图书馆数据库和 Google Scholar 中的随机对照试验（RCTs），使用了“心房颤动”和“秋水仙碱”这两个术语。主要终点是临床诊断为心房颤动的发生。使用相对风险（RR）和 95%置信区间（CI）进行评估。使用 DerSimonian-Laird 随机效应模型对估计值进行汇总。我们还根据秋水仙碱治疗的持续时间和剂量进行了亚组分析。
本荟萃分析共纳入 9 项 RCTs，共纳入 2031 例患者。秋水仙碱可显著降低 POAF 的发生率（RR 0.62；95%CI，0.52-0.74，P<0.001，I=0%）。亚组分析表明，秋水仙碱对 POAF 的保护作用在长疗程组（RR 0.60；95%CI，0.48-0.75，P<0.001，I=0%）中略强于短疗程组（RR 0.65；95%CI，0.49-0.86，P<0.001，I=0%）。
秋水仙碱可有效预防 POAF 的发生。秋水仙碱的疗效随着治疗时间的延长而略有增加，且无明显不良反应。
