Efficacy and safety of colchicine in patients with coronary artery disease: An updated meta-analysis of randomized controlled trials

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice Pub Date : 2025-09-13 DOI:10.1016/j.ahjo.2025.100610

Mushood Ahmed , Tallal Mushtaq Hashmi , Aimen Shafiq , Hadiah Ashraf , Hritvik Jain , Mohammed Y. Khanji , Rui Providência , Anwar A. Chahal , Jamal S. Rana , Muzammil Farhan , Raheel Ahmed , Marat Fudim , Gregg C. Fonarow

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Abstract

Background

Inflammation is associated with an increased risk of adverse cardiovascular events in patients with coronary artery disease (CAD). Colchicine is an anti-inflammatory drug that can be used to improve clinical outcomes in patients with CAD.

Methods

A systematic literature search was conducted across PubMed/MEDLINE, Embase, and Cochrane CENTRAL up to August 2025 to identify randomized controlled trials (RCTs) that reported clinical outcomes with the use of colchicine in CAD. Data for outcomes was extracted and summary estimates were generated using a random effects model.

Results

16 RCTs were included reporting data for 20,601 patients. The pooled analysis demonstrated a non-significant difference between colchicine and control groups for reducing all-cause death (RR: 0.97; 95 % CI, 0.78–1.22), cardiovascular death (RR: 0.98; 95 % CI, 0.79–1.21), and stroke (RR: 0.67; 95 % CI, 0.39–1.15). However, colchicine significantly reduced the risk of myocardial infarction (RR: 0.74; 95 % CI, 0.59–0.93), and ischemia-driven revascularization (RR = 0.72; 95 % CI, 0.53–0.99) at the expense of an increased risk of gastrointestinal adverse events (RR = 1.83; 95 % CI, 1.38–2.43) as compared to control.

Conclusion

Colchicine does not reduce the relative risk of all-cause and cardiovascular death in patients with CAD. However, it can reduce the risk of myocardial infarction and ischemia drive revascularization. Additional trial data are required to confirm these findings.

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秋水仙碱对冠心病患者的疗效和安全性：一项随机对照试验的最新荟萃分析

背景：炎症与冠状动脉疾病（CAD）患者不良心血管事件的风险增加有关。秋水仙碱是一种抗炎药物，可用于改善冠心病患者的临床结果。方法系统检索PubMed/MEDLINE、Embase和Cochrane CENTRAL截至2025年8月的文献，以确定报告秋水仙碱治疗CAD临床结果的随机对照试验（rct）。提取结果数据，并使用随机效应模型生成汇总估计。结果16项随机对照试验纳入20601例患者的报告数据。合并分析显示秋水仙碱与对照组在降低全因死亡（RR: 0.97; 95% CI, 0.78-1.22）、心血管死亡（RR: 0.98; 95% CI, 0.79-1.21）和卒中（RR: 0.67; 95% CI, 0.39-1.15）方面无显著差异。然而，与对照组相比，秋水仙碱显著降低了心肌梗死（RR: 0.74; 95% CI, 0.59-0.93）和缺血驱动的血运重建（RR = 0.72; 95% CI, 0.53-0.99）的风险，但却增加了胃肠道不良事件的风险（RR = 1.83; 95% CI, 1.38-2.43）。结论秋水仙碱不能降低冠心病患者全因死亡和心血管死亡的相对风险。然而，它可以降低心肌梗死和缺血驱动血运重建的风险。需要更多的试验数据来证实这些发现。

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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