Kommu Sharath, Arepally Shalini
Hospital Medicine, Marshfield Clinic Health System, Rice Lake, USA.
Family Medicine, Marshfield Clinic Health System, Rice Lake, USA.
Cureus. 2023 Feb 17;15(2):e35120. doi: 10.7759/cureus.35120. eCollection 2023 Feb.
Colchicine is a potent anti-inflammatory agent whose benefits have been explored for various conditions, including atrial fibrillation (AF). In this article, we tried to understand why colchicine might be beneficial in AF and reviewed various studies that looked at the effect of colchicine against AF. We followed the PRISMA algorithm and undertook a literature search to identify studies with control groups that looked at the effect of colchicine against AF and conducted a meta-analysis. We identified six studies on post-cardiac surgical patients, three on post-pulmonary vein isolation (PVI)/ablation patients, and two on coronary artery disease. In patients who underwent cardiac surgery, we found that colchicine is beneficial against postoperative atrial fibrillation (POAF) with a relative risk (RR) of 0.70 (95% CI of 0.58 to 0.84) and a p-value of 0.0001. We also found that in patients who underwent PVI/ablation, colchicine is beneficial in decreasing AF recurrence over three months with an RR of 0.57 (95% CI of 0.39 to 0.83) and a p-value of 0.0032 and over 12 months follow-up with an RR of 0.58 (95% CI of 0.42 - 0.80) and a p-value of 0.0008. Our meta-analysis showed that in patients with coronary artery disease, colchicine had no significant benefit in decreasing the incidence of AF with a hazard ratio (HR) of 0.86 (95% CI of 0.69 - 1.06) and a p-value of 0.16. From this study, we conclude that colchicine may be beneficial for decreasing the incidence of AF in post-cardiac surgery patients and post-PVI/ablation patients. It may not decrease the incidence of AF in patients with coronary artery disease.
秋水仙碱是一种强效抗炎药，其在包括心房颤动（AF）在内的多种病症中的益处已得到探索。在本文中，我们试图了解秋水仙碱为何可能对AF有益，并回顾了各项研究秋水仙碱对AF影响的研究。我们遵循PRISMA算法进行文献检索，以识别设有对照组且研究秋水仙碱对AF影响的研究，并进行了荟萃分析。我们确定了六项针对心脏手术后患者的研究、三项针对肺静脉隔离（PVI）/消融术后患者的研究以及两项针对冠状动脉疾病患者的研究。在接受心脏手术的患者中，我们发现秋水仙碱对预防术后心房颤动（POAF）有益，相对风险（RR）为0.70（95%置信区间为0.58至0.84），p值为0.0001。我们还发现，在接受PVI/消融术的患者中，秋水仙碱在三个月内降低AF复发率方面有益，RR为0.57（95%置信区间为0.39至0.83），p值为0.0032；在12个月的随访中，RR为0.58（95%置信区间为0.42 - 0.80），p值为0.0008。我们的荟萃分析表明，在冠状动脉疾病患者中，秋水仙碱在降低AF发生率方面无显著益处，风险比（HR）为0.86（95%置信区间为0.69 - 1.06），p值为0.16。从这项研究中，我们得出结论，秋水仙碱可能有助于降低心脏手术后患者和PVI/消融术后患者的AF发生率。它可能不会降低冠状动脉疾病患者的AF发生率。
