Jaiswal Vikash, Deb Novonil, Hanif Muhammad, Wajid Zarghoona, Nasir Yusra Minahil, Naz Sidra, Kalra Kriti, Qaiser Saria, Shrestha Abhigan Babu, Bandyopadhyay Dhrubajyoti, Mattumpuram Jishanth
Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USA.
North Bengal Medical College, Siliguri, West Bengal, India.
Am J Cardiovasc Drugs. 2025 Jan;25(1):83-93. doi: 10.1007/s40256-024-00689-7. Epub 2024 Oct 26.
Colchicine has been shown to reduce adverse cardiovascular events (ACE) and stroke among patients with coronary artery disease. However, its efficacy with short- and long-term use and risk of stroke has not been well studied, with conflicting results to date.
We sought to evaluate the efficacy of colchicine for the prevention of stroke and other cardiovascular outcomes and to evaluate the effect of short- and long-term use.
We performed a systematic literature search on PubMed, EMBASE, and Clinicaltrial.gov for relevant randomized controlled trials (RCTs) from inception until July 20th, 2024. Odds ratios (ORs) were pooled using a random-effect model, and a p value of < 0.05 was considered statistically significant.
A total of 16 RCTs with 24,967 patients were included (12,538 in colchicine group and 12,429 in the control group) in the analysis. Pooled analysis of primary outcomes showed that risk of incidence of stroke was comparable between colchicine and placebo groups (OR 0.78, 95% confidence interval [CI] 0.59-1.02, p = 0.07). Pooled analysis of secondary outcomes showed that colchicine significantly reduced the risk of incidence of ACE by 33% (OR 0.67, 95% CI 0.54-0.82, p < 0.001), and myocardial infarction by 21% (OR 0.79, 95% CI 0.65-0.95, p = 0.01) compared with placebo. However, the risk of all-cause mortality (OR 0.98, 95% CI 0.79-1.21, p = 0.83) and cardiovascular mortality (OR 0.78, 95% CI 0.56-1.08, p = 0.14) were comparable between both groups of patients.
Colchicine was associated with an overall reduction in the risk of incidence of ACE and MI; however, no such effect was observed with mortality and stroke.
秋水仙碱已被证明可降低冠状动脉疾病患者的不良心血管事件（ACE）和中风风险。然而，其短期和长期使用的疗效以及中风风险尚未得到充分研究，目前结果相互矛盾。
我们旨在评估秋水仙碱预防中风和其他心血管结局的疗效，并评估短期和长期使用的效果。
我们在PubMed、EMBASE和Clinicaltrial.gov上进行了系统的文献检索，以查找从开始到2024年7月20日的相关随机对照试验（RCT）。使用随机效应模型汇总比值比（OR），p值<0.05被认为具有统计学意义。
分析共纳入16项RCT，涉及24967名患者（秋水仙碱组12538名，对照组12429名）。主要结局的汇总分析显示，秋水仙碱组和安慰剂组的中风发病率风险相当（OR 0.78，95%置信区间[CI] 0.59 - 1.02，p = 0.07）。次要结局的汇总分析显示，与安慰剂相比，秋水仙碱显著降低了ACE发病率风险33%（OR 0.67，95% CI 0.54 - 0.82，p < 0.001），心肌梗死发病率风险降低21%（OR 0.79，95% CI 0.65 - 0.95，p = 0.01）。然而，两组患者的全因死亡率（OR 0.98，95% CI 0.79 - 1.21；p = 0.83）和心血管死亡率（OR 0.78，95% CI 0.56 - 1.08；p = 0.14）相当。
秋水仙碱与ACE和心肌梗死发病率风险的总体降低有关；然而，在死亡率和中风方面未观察到此类效果。
