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Background <p>Myocardial infarction (MI) triggers inflammation that affects post-MI outcomes. Colchicine shows potential in treating cardiovascular (CV) conditions; however, its role in reducing adverse CV events post-MI remains uncertain.</p> Methods <p>We conducted a thorough search across PubMed, Embase, Web of Science from inception to February 2025 for randomized controlled trials (RCTs) comparing colchicine and control in MI patients. Outcomes were analyzed using a random-effects model to pool relative risks (RRs) and mean differences (MD) with 95% confidence intervals (CIs).</p> Results <p>A total of 14 RCTs incorporating 14,326 patients were included. The incidence of adverse CV events, all-cause mortality, cardiac-specific mortality, non-cardiac specific mortality, recurrent MI, repeat revascularization and post-MI heart failure (HF), post-MI atrial fibrillation (AF), and stroke were comparable between colchicine and control groups. In both colchicine and control groups, a similar change in high-sensitivity C-reactive protein (hs-CRP) from the baseline was observed. Regarding the safety profile, both colchicine and control had overall comparable any adverse effects; however, gastrointestinal adverse events (RR: 1.74, 95% CI [1.20, 2.51], P = 0.003) were higher in the colchicine group. The incidence of myelotoxicity or infections was comparable between both groups.</p> Conclusions <p>Colchicine was not beneficial in reducing adverse CV events, mortality, recurrent MI, repeat revascularization, post-MI HF, post-MI AF, and stroke following acute MI compared to control. However, colchicine use was associated with a higher incidence of gastrointestinal adverse events, with no notable increase in any adverse effects, myelotoxicity, or infections.</p>

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Efficacy and safety of colchicine post myocardial infarction: a systematic review, meta-analysis and meta-regression analysis of randomized clinical trials

  • 期刊论文

  • 发表日期：

    2025年6月23日

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  • Farhan Naeem,
  • Shehroze Tabassum,
  • Muhammad Burhan,
  • Elsayed Balbaa,
  • Ahmed Ibrahim,
  • Shrouk Ramadan,
  • Usama Qamar,
  • Fatima Saeed,
  • Mohamed Abuelazm,
  • Dmitry Abramov,
  • Timir K. Paul,
  • Yasar Sattar

摘要

Background

Myocardial infarction (MI) triggers inflammation that affects post-MI outcomes. Colchicine shows potential in treating cardiovascular (CV) conditions; however, its role in reducing adverse CV events post-MI remains uncertain.

Methods

We conducted a thorough search across PubMed, Embase, Web of Science from inception to February 2025 for randomized controlled trials (RCTs) comparing colchicine and control in MI patients. Outcomes were analyzed using a random-effects model to pool relative risks (RRs) and mean differences (MD) with 95% confidence intervals (CIs).

Results

A total of 14 RCTs incorporating 14,326 patients were included. The incidence of adverse CV events, all-cause mortality, cardiac-specific mortality, non-cardiac specific mortality, recurrent MI, repeat revascularization and post-MI heart failure (HF), post-MI atrial fibrillation (AF), and stroke were comparable between colchicine and control groups. In both colchicine and control groups, a similar change in high-sensitivity C-reactive protein (hs-CRP) from the baseline was observed. Regarding the safety profile, both colchicine and control had overall comparable any adverse effects; however, gastrointestinal adverse events (RR: 1.74, 95% CI [1.20, 2.51], P = 0.003) were higher in the colchicine group. The incidence of myelotoxicity or infections was comparable between both groups.

Conclusions

Colchicine was not beneficial in reducing adverse CV events, mortality, recurrent MI, repeat revascularization, post-MI HF, post-MI AF, and stroke following acute MI compared to control. However, colchicine use was associated with a higher incidence of gastrointestinal adverse events, with no notable increase in any adverse effects, myelotoxicity, or infections.