Effect of colchicine in prevention of pericardial effusion and atrial fibrillation: a meta-analysis

Intern Emerg Med. 2016 Sep;11(6):867-76. doi: 10.1007/s11739-016-1496-5. Epub 2016 Jul 4.

Abstract

Randomized, controlled trials (RCTs) have assessed the effect of colchicine therapy in prevention of pericardial effusion (PE) and atrial fibrillation (AF). However, the effects are still inconclusive. PubMed, Cochrane Library, Google Scholar, and EMBASE database were searched. Primary outcome was the risk of PE and AF. Ten RCTs with 1981 patients and a mean follow-up of 12.6 months were included. Colchicine therapy was not associated with a significantly lower risk of post-operative PE (RR, 0.89; 95 % CI 0.70-1.13; p = 0.33, I (2) = 72.8 %) and AF (RR, 0.77; 95 % CI 0.52-1.13; p = 0.18, I (2) = 47.3 %). However, rates of pericarditis recurrence, symptoms persistence, and pericarditis-related hospitalization were significantly decreased with colchicine treatment. In addition, cardiac tamponade occurrence was similar between groups, and adverse events were significantly higher in the colchicine group. Colchicine may not significantly decrease the post-operative risk of PE and AF. However, only limited studies about patients undergoing cardiac surgery provide data about PE and AF.

Keywords: Atrial fibrillation; Cardiac tamponade; Colchicine; Pericardial effusion; Pericarditis recurrence.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / prevention & control*
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / statistics & numerical data
  • Chi-Square Distribution
  • Colchicine / pharmacology*
  • Colchicine / therapeutic use
  • Humans
  • Pericardial Effusion / drug therapy
  • Pericardial Effusion / prevention & control*
  • Pericarditis / drug therapy
  • Pericarditis / prevention & control
  • Recurrence

Substances

  • Colchicine