The efficacy of colchicine in preventing atrial fibrillation recurrence and pericarditis post-catheter ablation for atrial fibrillation - A systematic review and meta-analysis of prospective studies.
Int J Cardiol Heart Vasc
; 53: 101466, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-39156919
ABSTRACT
Introduction:
Catheter ablation (CA) initiates a proinflammatory process responsible for atrial fibrillation (AF) recurrence (25-40%) and pericarditis (0.8%). Due to its anti-inflammatory properties, colchicine, a microtubule inhibitor, is explored for the prevention of early AF recurrence and pericarditis after pulmonary vein isolation. We performed a pooled analysis to determine the rates of AF recurrence and pericarditis after CA in patients receiving colchicine.Methods:
A comprehensive literature review was conducted on PubMed and SCOPUS from inception to December 2023 using medical subject headings and keywords, followed by a citation and reference search. We identified prospective studies reporting recurrent AF and pericarditis outcomes after catheter ablation in patients taking colchicine versus placebo. A binary random effects model was used to estimate pooled odds ratios and 95% confidence intervals. Sensitivity analysis was conducted using the leave-one-out method, and heterogeneity was assessed using the I2 statistic.Results:
Of the 958 identified studies, 4 met our inclusion criteria. A total of 1,619 patients were analyzed; 743 received colchicine, and 875 were in the placebo group. Recurrent AF after CA occurred in 192 (29.0 %) of the colchicine group and 318 (39.5 %) of the placebo group. Post-ablation pericarditis occurred in 34 (5.3 %) of the colchicine group and 128 (16.5 %) of the placebo group. Pooled analysis of prospective studies showed that colchicine decreased the odds of recurrent AF [OR 0.63 (95 % CI 0.50-0.78), p < 0.01, I2 = 8 %] and post-ablation pericarditis [OR 0.34 (95 % CI 0.16-0.75), p < 0.01, I2 = 57 %]. Odds of GI disturbance were increased with colchicine use in our analysis [OR 2.77 (95 % CI 1.17-6.56), p = 0.02, I2 = 84 %].Conclusion:
Colchicine use is associated with decreased odds of recurrent AF and pericarditis post-CA from the analysis of prospective studies. These results underscore the potential for colchicine therapy for future exploration with randomized and controlled research with different dosages.
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Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos