The effect of 0.5 mg dose of colchicine on clinical outcomes in patients with acute myocardial infarction: An updated meta-analysis of randomized controlled trials
Ahmed Nazmy MD , Ahmed Sobhy MD , Ahmed Elshahat MD , Karim Atta MD , Mohamed R. Murad MD , Moustafa Ibrahim MD , Hassan El-Shirbiny MD , Rahma Abdelfattah Ibrahim MD , Mohamed Saad Sayed MD , Mahmoud Gomaa MD , Ahmed Yasser Shaban MD , Mohamed Naeem MD , Ahmed Abdelaziz MD
{"title":"The effect of 0.5 mg dose of colchicine on clinical outcomes in patients with acute myocardial infarction: An updated meta-analysis of randomized controlled trials","authors":"Ahmed Nazmy MD , Ahmed Sobhy MD , Ahmed Elshahat MD , Karim Atta MD , Mohamed R. Murad MD , Moustafa Ibrahim MD , Hassan El-Shirbiny MD , Rahma Abdelfattah Ibrahim MD , Mohamed Saad Sayed MD , Mahmoud Gomaa MD , Ahmed Yasser Shaban MD , Mohamed Naeem MD , Ahmed Abdelaziz MD","doi":"10.1016/j.cpcardiol.2025.103169","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Inflammation plays a critical role in the progression of atherosclerosis, and the anti-inflammatory effects on clinical outcomes of patients with acute myocardial infarction (AMI) are still uncertain.</div></div><div><h3>Objectives</h3><div>We aimed to study the effects of a 0.5 mg dose of colchicine on clinical outcomes following AMI.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Scopus, Web of Science, and Cochrane Central from inception to January 2025 for randomized controlled trials (RCTs) assessing 0.5 mg colchicine in AMI patients. The primary outcome was the incidence of major adverse cardiovascular events (MACE). Secondary outcomes included individual MACE components, cardiovascular (CV) and non-CV mortality, atrial fibrillation (AF), hospital readmission, and gastrointestinal (GIT) adverse events, including diarrhea.</div></div><div><h3>Results</h3><div>Ten RCTs involving 13,623 patients with a median follow-up of 6 months (range 5 days–36 months) were included. Low-dose colchicine showed a non-significant trend toward reducing MACE versus placebo (RR = 0.90, 95% CI: 0.80–1.01, p = 0.07; I² = 0%). Hospital readmission was significantly reduced by 49% (OR = 0.51, 95% CI: 0.26–0.98, p = 0.04; number needed to treat [NNT] = 25). Colchicine increased the risk of diarrhea (RR = 1.58, 95% CI: 1.06–2.36, p = 0.03; I² = 71%; number needed to harm [NNH] = 50) but showed no significant differences in all-cause mortality, CV mortality, myocardial infarction, stroke, or other GIT events.</div></div><div><h3>Conclusion</h3><div>Low-dose colchicine had a lower hospital readmission rate, but with higher rates of diarrhea compared to placebo. Long-term assessment is indeed to validate the current findings.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 11","pages":"Article 103169"},"PeriodicalIF":3.3000,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Problems in Cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0146280625001896","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Inflammation plays a critical role in the progression of atherosclerosis, and the anti-inflammatory effects on clinical outcomes of patients with acute myocardial infarction (AMI) are still uncertain.
Objectives
We aimed to study the effects of a 0.5 mg dose of colchicine on clinical outcomes following AMI.
Methods
We systematically searched PubMed, Scopus, Web of Science, and Cochrane Central from inception to January 2025 for randomized controlled trials (RCTs) assessing 0.5 mg colchicine in AMI patients. The primary outcome was the incidence of major adverse cardiovascular events (MACE). Secondary outcomes included individual MACE components, cardiovascular (CV) and non-CV mortality, atrial fibrillation (AF), hospital readmission, and gastrointestinal (GIT) adverse events, including diarrhea.
Results
Ten RCTs involving 13,623 patients with a median follow-up of 6 months (range 5 days–36 months) were included. Low-dose colchicine showed a non-significant trend toward reducing MACE versus placebo (RR = 0.90, 95% CI: 0.80–1.01, p = 0.07; I² = 0%). Hospital readmission was significantly reduced by 49% (OR = 0.51, 95% CI: 0.26–0.98, p = 0.04; number needed to treat [NNT] = 25). Colchicine increased the risk of diarrhea (RR = 1.58, 95% CI: 1.06–2.36, p = 0.03; I² = 71%; number needed to harm [NNH] = 50) but showed no significant differences in all-cause mortality, CV mortality, myocardial infarction, stroke, or other GIT events.
Conclusion
Low-dose colchicine had a lower hospital readmission rate, but with higher rates of diarrhea compared to placebo. Long-term assessment is indeed to validate the current findings.
期刊介绍:
Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.