Colchicine for prevention of major adverse cardiovascular events: a meta-analysis of randomized clinical trials.

IF 2.9 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Medicine Pub Date : 2025-06-06 DOI:10.2459/JCM.0000000000001744

Federico Ballacci, Federica Giordano, Cristina Conte, Alessandro Telesca, Valentino Collini, Massimo Imazio

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引用次数: 0

Abstract

Aims: Inflammation is a main pathophysiological driver in atherosclerotic cardiovascular diseases (ASCVD). Low-dose long-term colchicine for secondary prevention in patients with established ASCVD has been studied in multiple randomized trials in the last decade.This meta-analysis aimed to evaluate the efficacy and safety of long-term low-dose colchicine for secondary prevention in patients with established ASCVD.

Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines to evaluate studies reporting long-term outcomes in patients with ASCVD. We systematically searched PubMed, EMBASE and Scopus databases for relevant studies up to 1 December 2024. The primary outcome was the occurrence of major adverse cardiovascular events (MACE), a composite of cardiovascular death (CVD), myocardial infarction (MI) and stroke. Random-effects models were used to calculate pooled risk ratios (RRs).

Results: Ten randomized clinical trials enrolling 22 532 patients were identified. Addition of colchicine to standard medical treatment in patients with established ASCVD reduced the risk for MACE by 27% [RR 0.73, 95% confidence interval (CI) 0.57-0.95], with a number needed to treat of 52. Colchicine was found to significantly reduce the risk of MI (RR 0.83, 95% CI 0.72-0.96) and coronary revascularization (RR 0.79, 95% CI 0.65-0.94). There were no significant differences between the two groups concerning cardiovascular and noncardiovascular mortality, risk of serious gastrointestinal events, infections requiring hospitalization and cancer.

Conclusions: These findings support the use of long-term low-dose colchicine for secondary prevention of MACE in clinical practice.

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秋水仙碱预防主要不良心血管事件：随机临床试验的荟萃分析。

目的：炎症是动脉粥样硬化性心血管疾病（ASCVD）的主要病理生理驱动因素。在过去的十年中，多次随机试验研究了低剂量长期秋水仙碱对ASCVD患者二级预防的作用。本荟萃分析旨在评估长期低剂量秋水仙碱用于已确诊ASCVD患者二级预防的有效性和安全性。方法：我们根据PRISMA指南进行了系统回顾和荟萃分析，以评估报告ASCVD患者长期结局的研究。我们系统地检索了PubMed、EMBASE和Scopus数据库，检索了截至2024年12月1日的相关研究。主要结局是主要心血管不良事件（MACE）的发生，心血管死亡（CVD）、心肌梗死（MI）和卒中的复合。随机效应模型用于计算合并风险比（rr）。结果：10项随机临床试验纳入22 532例患者。在ASCVD患者的标准药物治疗中加入秋水仙碱可使MACE风险降低27% [RR 0.73, 95%可信区间（CI） 0.57-0.95]，需要治疗的人数为52人。发现秋水仙碱显著降低心肌梗死（RR 0.83, 95% CI 0.72-0.96）和冠状动脉血运重建术（RR 0.79, 95% CI 0.65-0.94）的风险。两组在心血管和非心血管死亡率、严重胃肠道事件风险、需要住院治疗的感染和癌症方面没有显著差异。结论：本研究结果支持临床长期低剂量秋水仙碱用于MACE的二级预防。

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

Journal of Cardiovascular Medicine 医学-心血管系统

CiteScore

3.90

自引率

26.70%

发文量

189

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Medicine is a monthly publication of the Italian Federation of Cardiology. It publishes original research articles, epidemiological studies, new methodological clinical approaches, case reports, design and goals of clinical trials, review articles, points of view, editorials and Images in cardiovascular medicine. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.