Zhu Shulai, Pan Weiwei, Yao Yingjie, Shi Kai
Department of Neurology, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, Linqing, China.
Department of Cadre Health Care, Qingdao Municipal Hospital, Qingdao, China.
Scand Cardiovasc J. 2025 Dec;59(1):2441112. doi: 10.1080/14017431.2024.2441112. Epub 2024 Dec 21.
Colchicine is an anti-inflammatory drug with promising efficacy for preventing cardiovascular events. We aimed to assess the pooled effect of colchicine on ischemic stroke among patients with established atherosclerotic cardiovascular diseases. . PubMed, Scopus, Web of Science, and the Cochrane Library were systematically searched from the inception to August 5, 2024. A random-effects (DerSimonian-Laird) model was used to conduct this meta-analysis. The inclusion criteria were as follows: (I) being a randomized controlled trial; and (II) measuring the efficacy of colchicine compared to placebo for preventing ischemic stroke among those with established atherosclerotic cardiovascular diseases. . We identified 13 eligible clinical trials with 24900 participants. Colchicine significantly decreased the risk of ischemic stroke (relative risk (RR) 0.85, 95% confidence interval (CI) (0.72, 0.99), I=2.92%) among those with established atherosclerotic cardiovascular diseases. Colchicine was more effective when used at 0.5 mg/day (RR 0.86, 95% CI (0.75, 0.99)), prescribed for more than 30 days (RR 0.86, 95% CI (0.75, 1.00)) or for more than 90 days (RR 0.65, 95% CI (0.46, 0.92)), or administered for patients with acute coronary syndrome (RR 0.46, 95% CI (0.23, 0.92)). In addition, colchicine was more effective in studies with a sample size of more than 500 patients, consistent with sensitivity analysis, which indicated that the results relied on large-sized clinical trials. . Colchicine may decrease the risk of ischemic stroke among patients with established atherosclerotic cardiovascular diseases, particularly after long-term use; however, future studies are needed due to inconsistencies between existing trials.
秋水仙碱是一种抗炎药物，在预防心血管事件方面具有显著疗效。我们旨在评估秋水仙碱对已确诊动脉粥样硬化性心血管疾病患者缺血性中风的综合影响。从数据库建立至2024年8月5日，我们系统检索了PubMed、Scopus、Web of Science和Cochrane图书馆。采用随机效应（DerSimonian-Laird）模型进行这项荟萃分析。纳入标准如下：（I）为随机对照试验；（II）测量秋水仙碱与安慰剂相比，对已确诊动脉粥样硬化性心血管疾病患者预防缺血性中风的疗效。我们确定了13项符合条件的临床试验，共24900名参与者。在已确诊动脉粥样硬化性心血管疾病的患者中，秋水仙碱显著降低了缺血性中风的风险（相对风险（RR）为0.85，95%置信区间（CI）为（0.72，0.99），I² = 2.92%）。当秋水仙碱以0.5毫克/天的剂量使用时（RR为0.86，95% CI为（0.75，0.99））、给药超过30天（RR为0.86，95% CI为（0.75，1.00））或超过90天（RR为0.65，95% CI为（0.46，0.92）），或用于急性冠状动脉综合征患者时（RR为0.46，95% CI为（0.23，0.92）），其效果更佳。此外，在样本量超过500名患者的研究中，秋水仙碱效果更佳，这与敏感性分析结果一致，表明结果依赖于大型临床试验。秋水仙碱可能会降低已确诊动脉粥样硬化性心血管疾病患者缺血性中风的风险，尤其是长期使用后；然而，由于现有试验之间存在不一致性，仍需要进一步的研究。
