부산대학교 도서관

Background. Colchicine has shown potential cardioprotective efects owing to its broad anti-infammatory properties. We performed a meta-analysis to assess its safety and efcacy in secondary prevention in patients with established coronary artery disease (CAD). Methods. We searched Ovid Healthstar, MEDLINE, and Embase (inception to May 2022) for randomized controlled trials (RCTs) evaluating the cardiovascular efects of colchicine compared with placebo or usual care in patients with CAD. Study-level data on efcacy and safety outcomes were pooled using the Peto method. Te primary outcome was the composite of cardiovascular (CV) death, myocardial infarction (MI), or stroke. Results. A total of 8 RCTs were included with a follow-up duration of ≥1 month, comprising a total of 12,151 patients. Compared with placebo or usual care, colchicine was associated with a signifcant risk reduction in the primary outcome (odds ratio (OR) 0.70, 95% CI 0.60 to 0.83, P < 0.0001; I² = 52%). Risks of MI (OR 0.75, 95% CI 0.62 to 0.91, P = 0.003; I² = 33%), stroke (OR 0.47, 95% CI 0.30 to 0.74, P = 0.001; I² = 0%), and unplanned coronary revascularization (OR 0.67, 95% CI 0.55 to 0.82, P = 0.0001; I² = 58%) were all reduced in the colchicine group. Rates of CV and all-cause mortality did not difer between the two groups, but there was an increase in noncardiac deaths with colchicine (OR 1.54, 95% CI 1.10 to 2.15, P = 0.01; I² = 51%). Te occurrence of all other adverse events was similar between the two groups, including GI reactions (OR 1.06, 95% CI 0.94 to 1.20, P = 0.35; I² = 42%) and infections (OR 1.04, 95% CI 0.84 to 1.28, P = 0.74; I² = 53%). Conclusions. Colchicine therapy may reduce the risk of future cardiovascular events in patients with established CAD; however, there remains a concern about non-CV mortality. Further trials are underway that will shed light on non-CV mortality and colchicine NCT03048825, and NCT02898610. [ABSTRACT FROM AUTHOR]