Abdelsayed Kerollos, Amer Basma Ehab, Almahdy Mohamed Ahmed, Fouad Michele, Amin Ahmed Mazen, Ibrahim Mahmoud Mahmoud, Thangjui Sittinun, Abdelazeem Basel, Balla Sudarshan, Latib Azeem
Heart Rhythm Science Center Minneapolis Heart Institute Foundation Minneapolis MN USA.
Clinical Research Department, Aswan Heart Centre Magdi Yacoub Foundation Aswan Egypt.
J Am Heart Assoc. 2025 Aug 5;14(15):e043791. doi: 10.1161/JAHA.125.043791. Epub 2025 Jul 29.
Conduction disturbances are frequent complications following transcatheter aortic valve intervention (TAVI), partially driven by inflammation. The anti-inflammatory role of colchicine on these disorders post TAVI has not been studied yet. Therefore, we investigated the association between preoperative colchicine use and conduction disturbances after TAVI.
We used the TriNetX platform, a data repository of health record data from health care organizations in the United States, to identify patients receiving any colchicine prescription within 3 months before their first TAVI and compared them to propensity score matched patients never exposed to colchicine up to 1 year after the procedure. Primary outcomes included new-onset or worsening atrioventricular or left bundle-branch block (LBBB) and heart block (HB) postoperatively. Outcomes were assessed within 1 and 6 months after TAVI with an E-sensitivity analysis assessing the impact of unmeasured confounders.
Of 52 860 patients, 705 were on preoperative colchicine. After matching, each group included 702 patients. Colchicine was associated with a statistically significant reduction of new-onset or worsening atrioventricular/left bundle-branch block and heart block post TAVI at 1 month (relative risk [RR], 0.867 [95% CI, 0.756-0.994], =0.041; RR, 0.887 [95% CI, 0.788-0.999], =0.047, respectively) but not at 6 months (RR, 0.886 [95% CI, 0.779-1.077], =0.064; RR, 0.913 [95% CI, 0.817-1.020], =0.109, respectively). The E-value was >1.5 for the statistically significant outcomes.
Preoperative colchicine was associated with a lower incidence of new-onset or worsening atrioventricular/left bundle-branch block and heart block after TAVI at 1 month. However, no significant difference was observed at 6 months. Future prospective studies are needed to evaluate the definitive role of colchicine in improving TAVI outcomes.
传导障碍是经导管主动脉瓣介入治疗（TAVI）后常见的并发症，部分由炎症驱动。秋水仙碱对TAVI后这些疾病的抗炎作用尚未得到研究。因此，我们研究了术前使用秋水仙碱与TAVI后传导障碍之间的关联。
我们使用TriNetX平台，这是一个来自美国医疗保健机构的健康记录数据存储库，以识别在首次TAVI前3个月内接受任何秋水仙碱处方的患者，并将他们与倾向评分匹配的、在术后1年内从未接触过秋水仙碱的患者进行比较。主要结局包括术后新发或恶化的房室传导阻滞或左束支传导阻滞（LBBB）以及心脏传导阻滞（HB）。在TAVI后1个月和6个月内评估结局，并进行E敏感性分析以评估未测量混杂因素的影响。
在52860例患者中，705例术前使用秋水仙碱。匹配后，每组包括702例患者。秋水仙碱与TAVI后1个月时新发或恶化的房室传导阻滞/左束支传导阻滞和心脏传导阻滞的发生率在统计学上显著降低相关（相对风险[RR]，0.867[95%CI，0.756 - 0.994]，P = 0.041；RR，0.887[95%CI，0.788 - 0.999]，P = 0.047），但在6个月时无相关性（RR，0.886[95%CI，0.779 - 1.077]，P = 0.064；RR，0.913[95%CI，0.817 - 1.020]，P = 0.109）。具有统计学显著性的结局的E值>1.5。
术前使用秋水仙碱与TAVI后1个月时新发或恶化的房室传导阻滞/左束支传导阻滞和心脏传导阻滞的发生率较低相关。然而，在6个月时未观察到显著差异。需要未来的前瞻性研究来评估秋水仙碱在改善TAVI结局中的明确作用。
