The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials

<h3>Introduction</h3><p dir="ltr">Myocardial infarction (MI) is associated with a significant post-event inflammatory response which further contributes to post-MI prognosis. Colchicine, an anti-inflammatory agent, exhibits potential benefits in various cardiovascular con...

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Main Author: Ayesha Younas (7114868) (author)
Other Authors: Zainab Awan (20151435) (author), Tehreem Khan (20151438) (author), Samay Mehta (17789705) (author), Aqsa Munir (9073801) (author), Hafsa Arshad Azam Raja (20151441) (author), Hritvik Jain (19757091) (author), Ahmed Raza (170325) (author), Ayesha Sehar (20151444) (author), Raheel Ahmed (450330) (author), Abdulqadir J. Nashwan (11659453) (author)
Published: 2025
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author Ayesha Younas (7114868)
author2 Zainab Awan (20151435)
Tehreem Khan (20151438)
Samay Mehta (17789705)
Aqsa Munir (9073801)
Hafsa Arshad Azam Raja (20151441)
Hritvik Jain (19757091)
Ahmed Raza (170325)
Ayesha Sehar (20151444)
Raheel Ahmed (450330)
Abdulqadir J. Nashwan (11659453)
author2_role author
author
author
author
author
author
author
author
author
author
author_facet Ayesha Younas (7114868)
Zainab Awan (20151435)
Tehreem Khan (20151438)
Samay Mehta (17789705)
Aqsa Munir (9073801)
Hafsa Arshad Azam Raja (20151441)
Hritvik Jain (19757091)
Ahmed Raza (170325)
Ayesha Sehar (20151444)
Raheel Ahmed (450330)
Abdulqadir J. Nashwan (11659453)
author_role author
dc.creator.none.fl_str_mv Ayesha Younas (7114868)
Zainab Awan (20151435)
Tehreem Khan (20151438)
Samay Mehta (17789705)
Aqsa Munir (9073801)
Hafsa Arshad Azam Raja (20151441)
Hritvik Jain (19757091)
Ahmed Raza (170325)
Ayesha Sehar (20151444)
Raheel Ahmed (450330)
Abdulqadir J. Nashwan (11659453)
dc.date.none.fl_str_mv 2025-01-01T00:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.cpcardiol.2024.102878
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/The_effect_of_colchicine_on_myocardial_infarction_An_updated_systematic_review_and_meta-analysis_of_randomized_controlled_trials/27643104
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Pharmacology and pharmaceutical sciences
Health sciences
Epidemiology
Public health
Colchicine
Inflammation
MI
Myocardial infarction
Cardiovascular death
Anti-inflammatories
Outcomes
CRP
dc.title.none.fl_str_mv The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Introduction</h3><p dir="ltr">Myocardial infarction (MI) is associated with a significant post-event inflammatory response which further contributes to post-MI prognosis. Colchicine, an anti-inflammatory agent, exhibits potential benefits in various cardiovascular conditions such as coronary artery disease, pericarditis and atrial fibrillation. This meta-analysis predominantly aimed to provide an up-to-date evaluation of the efficacy and safety of colchicine in reducing adverse cardiovascular events in patients following acute MI.</p><h3>Methods</h3><p dir="ltr">A Comprehensive search was conducted on PubMed, Cochrane Library, Scopus, Google Scholar and clinicaltrials.gov for randomized controlled trials (RCTs) investigating the effect of colchicine on patients with MI from inception till May 2024. Our primary outcome was a composite of adverse cardiovascular events, while secondary outcomes included all-cause mortality, incidence of stroke, incidence of cardiac arrest, hospitalization urgency, incidence of recurrent MI, adverse gastrointestinal events and levels of high-sensitivity C - reactive protein (Hs-CRP). Risk ratios (RR) and mean differences (MD) were pooled under the random-effects model.</p><h3>Results</h3><p dir="ltr">Eleven trials with 7161 patients were included in our analysis out of which 3546 (49.51 %) were allocated to colchicine and 3591 (50.14 %) received placebo. Colchicine demonstrated statistically significant reduction in the composite of adverse cardiovascular events (RR = 0.75, 95 % CI: 0.60-0.94, P = 0.01, I<sup>2</sup> = 47 %), and hospitalization urgency (RR = 0.46, 95 % CI: 0.31-0.68, P = 0.0001, I<sup>2</sup> = 0 %) but statistically significant increment in adverse gastrointestinal events (RR = 1.86, 95 % CI: 1.14-3.02, P = 0.01, I<sup>2</sup> = 79 %). However, all-cause mortality (RR = 1.00, 95 % CI: 0.72-1.39, P = 0.98, I<sup>2</sup> = 0 %), incidence of cardiac arrest (RR = 0.81, 95 % CI: 0.33-1.95, P = 0.63, I<sup>2</sup> = 0), incidence of stroke (RR = 0.45, 95 % CI: 0.17-1.19, P = 0.11, I<sup>2</sup> = 36 %), incidence of recurrent MI (RR = 0.78, 95 % CI: 0.57-1.06, P = 0.11, I<sup>2</sup> = 11 %) and the levels of hs-CRP (MD= -0.87, 95 %CI: -1.80-0.06, P=0.07, I<sup>2</sup>=67 % remained comparable across the two groups.</p><h3>Conclusion</h3><p dir="ltr">The use of colchicine post-MI reduces the composite of adverse cardiovascular events, and hospitalization urgency but increases adverse gastrointestinal events. However, colchicine does not impact all-cause mortality, cardiac arrest, stroke incidence, incidence of recurrent MI and the levels of hs-CRP. Large scale multicenter RCTs especially with longer follow-up duration are warranted to validate these findings.</p><h2>Other Information</h2><p dir="ltr">Published in: Current Problems in Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.cpcardiol.2024.102878" target="_blank">https://dx.doi.org/10.1016/j.cpcardiol.2024.102878</a></p>
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spelling The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trialsAyesha Younas (7114868)Zainab Awan (20151435)Tehreem Khan (20151438)Samay Mehta (17789705)Aqsa Munir (9073801)Hafsa Arshad Azam Raja (20151441)Hritvik Jain (19757091)Ahmed Raza (170325)Ayesha Sehar (20151444)Raheel Ahmed (450330)Abdulqadir J. Nashwan (11659453)Biomedical and clinical sciencesCardiovascular medicine and haematologyPharmacology and pharmaceutical sciencesHealth sciencesEpidemiologyPublic healthColchicineInflammationMIMyocardial infarctionCardiovascular deathAnti-inflammatoriesOutcomesCRP<h3>Introduction</h3><p dir="ltr">Myocardial infarction (MI) is associated with a significant post-event inflammatory response which further contributes to post-MI prognosis. Colchicine, an anti-inflammatory agent, exhibits potential benefits in various cardiovascular conditions such as coronary artery disease, pericarditis and atrial fibrillation. This meta-analysis predominantly aimed to provide an up-to-date evaluation of the efficacy and safety of colchicine in reducing adverse cardiovascular events in patients following acute MI.</p><h3>Methods</h3><p dir="ltr">A Comprehensive search was conducted on PubMed, Cochrane Library, Scopus, Google Scholar and clinicaltrials.gov for randomized controlled trials (RCTs) investigating the effect of colchicine on patients with MI from inception till May 2024. Our primary outcome was a composite of adverse cardiovascular events, while secondary outcomes included all-cause mortality, incidence of stroke, incidence of cardiac arrest, hospitalization urgency, incidence of recurrent MI, adverse gastrointestinal events and levels of high-sensitivity C - reactive protein (Hs-CRP). Risk ratios (RR) and mean differences (MD) were pooled under the random-effects model.</p><h3>Results</h3><p dir="ltr">Eleven trials with 7161 patients were included in our analysis out of which 3546 (49.51 %) were allocated to colchicine and 3591 (50.14 %) received placebo. Colchicine demonstrated statistically significant reduction in the composite of adverse cardiovascular events (RR = 0.75, 95 % CI: 0.60-0.94, P = 0.01, I<sup>2</sup> = 47 %), and hospitalization urgency (RR = 0.46, 95 % CI: 0.31-0.68, P = 0.0001, I<sup>2</sup> = 0 %) but statistically significant increment in adverse gastrointestinal events (RR = 1.86, 95 % CI: 1.14-3.02, P = 0.01, I<sup>2</sup> = 79 %). However, all-cause mortality (RR = 1.00, 95 % CI: 0.72-1.39, P = 0.98, I<sup>2</sup> = 0 %), incidence of cardiac arrest (RR = 0.81, 95 % CI: 0.33-1.95, P = 0.63, I<sup>2</sup> = 0), incidence of stroke (RR = 0.45, 95 % CI: 0.17-1.19, P = 0.11, I<sup>2</sup> = 36 %), incidence of recurrent MI (RR = 0.78, 95 % CI: 0.57-1.06, P = 0.11, I<sup>2</sup> = 11 %) and the levels of hs-CRP (MD= -0.87, 95 %CI: -1.80-0.06, P=0.07, I<sup>2</sup>=67 % remained comparable across the two groups.</p><h3>Conclusion</h3><p dir="ltr">The use of colchicine post-MI reduces the composite of adverse cardiovascular events, and hospitalization urgency but increases adverse gastrointestinal events. However, colchicine does not impact all-cause mortality, cardiac arrest, stroke incidence, incidence of recurrent MI and the levels of hs-CRP. Large scale multicenter RCTs especially with longer follow-up duration are warranted to validate these findings.</p><h2>Other Information</h2><p dir="ltr">Published in: Current Problems in Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.cpcardiol.2024.102878" target="_blank">https://dx.doi.org/10.1016/j.cpcardiol.2024.102878</a></p>2025-01-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.cpcardiol.2024.102878https://figshare.com/articles/journal_contribution/The_effect_of_colchicine_on_myocardial_infarction_An_updated_systematic_review_and_meta-analysis_of_randomized_controlled_trials/27643104CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/276431042025-01-01T00:00:00Z
spellingShingle The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials
Ayesha Younas (7114868)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Pharmacology and pharmaceutical sciences
Health sciences
Epidemiology
Public health
Colchicine
Inflammation
MI
Myocardial infarction
Cardiovascular death
Anti-inflammatories
Outcomes
CRP
status_str publishedVersion
title The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials
title_full The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials
title_fullStr The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials
title_short The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials
title_sort The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Pharmacology and pharmaceutical sciences
Health sciences
Epidemiology
Public health
Colchicine
Inflammation
MI
Myocardial infarction
Cardiovascular death
Anti-inflammatories
Outcomes
CRP