Background: Postoperative atrial fibrillation (POAF) is a common medical problem with estimated incidence up to 60% in cardiac surgery. Several drugs have been evaluated for the prevention of POAF including amiodarone, beta blaokers, magnesium, statins and colchicine. However, there have been conflicting studies supporting colchicine as an effective drug for prevention of POAF. A meta-analysis of randomized controlled trials (RCT) was conducted comparing colchicine versus placebo to evaluate the reduction in the rate of POAF. Methods: We conducted a comprehensive search of PubMed, Ovid Medline, and Cochrane library database for randomized control trials (RCT), using terms ''colchicine, postoperative atrial fibrillation'. The primary endpoint was POAF. The safety end point was any side effects. Odds ratios (OR) and 95% confidence intervals (CI) computed using the Mantel-Haenszel method. Fixed-effect model was used. Results: A total of three RCT were included in the meta-analysis, enrolling a total of 857 patients. Colchicine significantly reduced the rate of POAF (OR 0.579; 95% CI, 0.423-0.792, P = 0.001, I2 = 17.9) but when compared with the placebo, the risk of side effects was higher with colchicine (OR 2.080; 95% CI, 1.328-3.257, P = 0.001, I2= 0). The Number need to treated was 10 and Number needed to harm was 15, with net positive balance Conclusion: Colchicine is an effective drug for prevention of POAF with relatively higher side effects when compared to placebo.
Salih, M., Smer, A., Elmasry, Y., Mlatoum, H., & Spinetto, P. V. (2015). COLCHICINE FOR PREVENTION OF POSTOPERATIVE ATRIAL FIBRILLATION: META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. Journal of the American College of Cardiology, 65(10), A268. https://doi.org/10.1016/s0735-1097(15)60268-6