Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Postpericardiotomy syndrome (PPS) and atrial fibrillation (AF) are complications occurred in one-third of cardiac surgery patients that increase morbidity and mortality. Colchicine is an anti-inflammatory drug for treating acute pericarditis and pericardial effusion. Previous studies suggested that colchicine also may prevent PPS and AF after cardiac surgery although the results were still inconsistent.
Purpose
This study intends to determine the efficacy of colchicine for preventing PPS and AF in post-cardiac surgery patients.
Methods
We conducted comprehensive literature searching in online databases of Pubmed, EMBASE, ScienceDirect, and The Cochrane Library, to include all relevant studies until November 2020. We included all randomized controlled trials (RCTs) that access the incidence of PPS and AF after cardiac surgery in patients who received colchicine before cardiac surgery compared with placebo. We use revised Cochrane risk-of-bias tool (RoB 2) for accessing the bias risk of included studies. We performed analysis to provide pooled risk ratio (RR) with 95% confidence interval (CI) using fixed-effect heterogeneity test.
Results
We included 9 RCTs with total of 2,372 participants met our inclusion criteria. The administration of colchicine before cardiac surgery decreases the incidence of PPS significantly (pooled RR = 0.55, 95% CI 0.43 – 0.71, p < 0.00001. I² = 0%). Besides, colchicine also significantly lowers the incidence of postoperative AF compared with placebo (pooled RR = 0.79, 95% CI 0.65 – 0.96, p = 0.02. I² = 20%).
Conclusions
Colchicine showed potential benefits for preventing PPS and AF after cardiac surgery. However, further trials are needed to establish the efficacies.
Fish Oil and Atrial Fibrillation after Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials
