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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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07. Syncope and Bradycardia
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30. Cardiovascular Disease in Special Populations
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32. Cardiovascular Nursing
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Colchicine for Cardiovascular Prevention in High-Risk Cardiovascular Patients: a systematic review and meta-analysis
Session:
Posters - G. Aortic Disease, Peripheral Vascular Disease, Stroke
Speaker:
Gonçalo Ferraz Costa
Congress:
CPC 2021
Topic:
G. Aortic Disease, Peripheral Vascular Disease, Stroke
Theme:
24. Stroke
Subtheme:
24.5 Stroke - Prevention
Session Type:
Posters
FP Number:
---
Authors:
Gonçalo Ferraz Costa; Lino Gonçalves; Rogerio Teixeira
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Background</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: Colchicine has emerged as an anti-inflammatory therapy for high-cardiovascular risk patients. </span></span></span></span></p> <p> </p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Purpose</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: To assess colchicine’s efficacy and safety in high cardiovascular risk patients.</span></span></span></span></p> <p> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Methods</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: We systematically searched PubMed, Embase and Cochrane databases, in December 2020, for interventional studies comparing colchicine with placebo in high-risk cardiovascular patients. Main endpoints were stroke, myocardial infarction, urgent revascularization, cardiovascular and all-cause mortality, and gastrointestinal adverse events.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Results</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: Eleven randomized clinical trials were included, providing a total of 12275 patients, 82 pooled stroke events, 441 pooled myocardial infarction events and 402 urgent revascularization events. Meta-analysis showed a significantly lower stroke events for the colchicine compared with placebo group (pooled OR 0.49 [0.30, 0.78], P=0.003, I<sup>2</sup>=0%). Additionally, colchicine group presented a lower myocardial infarction rate (pooled OR 0.64 [0.43, 0.94], P=0.02, I<sup>2</sup>=56%) and urgent revascularization rate (pooled OR 0.57 [0.36, 0.91], P=0.02, I<sup>2</sup>=58%) despite the significant heterogeneity identified in both outcomes. Nevertheless, no significant differences were noted regarding cardiovascular and all -cause mortality as identified (pooled OR 0.79 [0.42, 1.46], P=0.45, I<sup>2</sup>=37%; pooled OR 1.04 [0.68, 1.61], P=0.85, I<sup>2</sup>=37%, respectively). In terms of safety, there was a significant higher rate of gastrointestinal adverse events (pooled OR 1.76 [1.27, 2.43], P=0.006, I<sup>2</sup>=66%).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Conclusions</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: According to our meta-analysis, colchicine use reduced cardio and cerebrovascular events in high-risk cardiovascular patients, although it had no impact on mortality.</span></span></span></span></p>
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