Do Colchicine and Prednisone Affect the Rate of Recurrence of Post-Pericardiotomy Syndrome

Isr Med Assoc J. 2020 Feb;22(2):79-82.

Abstract

Background: Post-pericardiotomy syndrome (PPS) is a major cause of pericarditis, yet data on the risk of recurrence are limited, and the impact of steroids and colchicine in this context is unknown.

Objectives: To examine the effect of prednisone and colchicine on the rate of recurrence of PPS.

Methods: Medical files of patients diagnosed with PPS were reviewed to extract demographic, echocardiographic, X-ray imaging, and follow-up data.

Results: The study comprised 132 patients (57% men), aged 27-86 years. Medical treatment included prednisone in 80 patients, non-steroidal anti-inflammatory agents in 41 patients, colchicine monotherapy in 2 patients, and no anti-inflammatory therapy in 9 patients. Fifty-nine patients were given colchicine for prevention of recurrence. The patients were followed for 5-110 months (median 64 months). Recurrent episodes occurred in 15 patients (11.4%), 10 patients had a single episode, 4 patients had two episodes, and one patient had three episodes. The rate of recurrence was lower in patients receiving colchicine compared to patients who did not (8.5% vs. 13.7%), and in patients not receiving vs. receiving prednisone (7.7% vs. 13.8%) but the differences were non-significant. Twenty-three patients died and there were no recurrence-related deaths.

Conclusions: The rate of recurrence after PPS is low and multiple recurrences are rare. The survival of patients with recurrent PPS is excellent. Prednisone pre-treatment was associated with a numerically higher rate of recurrence and colchicine treatment with a numerically lower rate, but the differences were non-significant.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents / therapeutic use*
  • Colchicine / therapeutic use*
  • Echocardiography / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Israel
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Pericardiectomy / adverse effects*
  • Pericardiectomy / methods
  • Postpericardiotomy Syndrome* / diagnosis
  • Postpericardiotomy Syndrome* / drug therapy
  • Postpericardiotomy Syndrome* / etiology
  • Prednisone / therapeutic use*
  • Radiography, Thoracic / methods
  • Secondary Prevention / methods

Substances

  • Anti-Inflammatory Agents
  • Colchicine
  • Prednisone