Efficacy of colchicine in lower extremity peripheral arterial disease: A meta-analysis

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2025-04-24 DOI:10.1016/j.hrtlng.2025.04.022

Hritvik Jain MBBS , Nandan Patel MBBS , Maheen Erum MBBS , Ramez M. Odat MD , Siddhant Passey MD , Rozi Khan MD , Jyoti Jain MBBS , Ameer Haider Cheema MD , Sebastian Fox MBChB, BMSc , Raheel Ahmed MBBS, MRCP

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引用次数: 0

Abstract

Background

Lower-extremity peripheral arterial disease (LEPAD) significantly increases the risk of severe cardiovascular and limb complications, often due to the underlying inflammation from atherosclerosis. Colchicine has gained attention due to its efficacy in the primary and secondary prevention of cardiovascular events and may offer similar protective benefits for LEPAD.

Objectives

This meta-analysis aimed to evaluate outcomes with colchicine in LEPAD.

Methods

A systematic literature search was performed on the major bibliographic databases for studies until October 2024. Hazard ratios (HRs) with their corresponding 95% CIs were pooled using the inverse-variance random-effects model.

Results

Three studies were included with 226,804 patients [113,537: Colchicine and 113,267: Placebo]. The pooled analysis demonstrates colchicine use in patients with LEPAD was associated with a significantly lower risk of major adverse limb events (MALE) [HR: 0.84; 95 % CI: 0.75, 0.94; p = 0.002], major adverse cardiovascular events (MACE) [HR: 0.90; 95 % CI: 0.82, 0.98; p = 0.02], ischemic stroke [HR: 0.97; 95 % CI: 0.94, 0.99; p = 0.02], need for major amputations [HR: 0.81, 95 % CI: 0.75, 0.87; p< 0.00001], and revascularization for lower limb ischemia [HR: 0.81; 95 % CI: 0.72, 0.90; p = 0.0001]. However, no significant reduction was noted for all-cause mortality [HR: 0.87; 95 % CI: 0.74, 1.02; p = 0.09] and myocardial infarction (MI) [HR: 0.98; 95 % CI: 0.95, 1.00; p = .10].

Conclusion

Colchicine may be a useful adjunctive therapy for reducing the risk of major cardiovascular and limb-related complications in patients with LEPAD, including lower rates of MACE, MALE, stroke, amputation, and limb ischemia. However, it did not significantly reduce all-cause mortality or MI. Notably, the only randomized trial evaluating colchicine's efficacy in LEPAD reported a similar risk of adverse outcomes. Multicenter, adequately powered randomized controlled trials are needed to confirm colchicine's effectiveness in this population.

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秋水仙碱治疗下肢外周动脉疾病的疗效：荟萃分析

背景下肢外周动脉疾病（LEPAD）大大增加了严重心血管和肢体并发症的风险，这通常是由于动脉粥样硬化引起的潜在炎症所致。秋水仙碱因其在心血管事件一级和二级预防中的疗效而备受关注，并可能为 LEPAD 提供类似的保护性益处。结果共纳入三项研究，226804 名患者[113537 名：秋水仙碱，113267 名：安慰剂]。汇总分析表明，LEPAD 患者使用秋水仙碱与主要肢体不良事件 (MALE) [HR: 0.84; 95 % CI: 0.75, 0.94; p = 0.002]、主要心血管不良事件 (MACE) [HR: 0.90; 95 % CI: 0.82, 0.98; p = 0.02]、缺血性中风[HR：0.97; 95 % CI: 0.94, 0.99; p = 0.02]、主要截肢需求[HR：0.81, 95 % CI: 0.75, 0.87; p< 0.00001]和下肢缺血血管重建[HR：0.81; 95 % CI: 0.72, 0.90; p = 0.0001]。然而，全因死亡率[HR：0.87；95 % CI：0.74，1.02；p = 0.09]和心肌梗死（MI）[HR：0.98；95 % CI：0.95，1.00；p = .10]没有明显降低。结论秋水仙碱可能是一种有效的辅助疗法，可降低 LEPAD 患者发生主要心血管和肢体相关并发症的风险，包括降低 MACE、MALE、中风、截肢和肢体缺血的发生率。但是，它并没有明显降低全因死亡率或心肌梗死率。值得注意的是，唯一一项评估秋水仙碱对 LEPAD 疗效的随机试验也报告了类似的不良后果风险。要确认秋水仙碱在这一人群中的疗效，还需要进行多中心、充分有效的随机对照试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.