Colchicine does not significantly reduce perioperative atrial fibrillation (AF) or myocardial injury after non-cardiac surgery (MINS) in patients undergoing major non-cardiac thoracic surgery, according to late breaking research presented in a Hot Line session today at ESC Congress 2023.
Perioperative AF occurs in approximately 10% of patients after major thoracic surgery, while MINS has an incidence of about 20% in the same patient population. Patients with perioperative AF and MINS have a poor prognosis. High levels of inflammatory biomarkers have been associated with an increased risk of perioperative AF and MINS. Anti-inflammatory treatment therefore has the potential to reduce the incidence of these two prognostically important complications.
The study included 3,209 patients from 45 sites in 11 countries. The mean age was 68 years and 48.4% were women. Clinically important AF developed in 103 of 1,608 patients assigned to colchicine and 120 of 1,601 patients assigned to placebo, for a hazard ratio of 0.85 and absolute risk reduction of 1.1% . MINS occurred in 295 patients assigned to colchicine and 325 patients assigned to placebo, HR 0.89 and ARR 2.0% .
In post-hoc analyses, the composite outcome of clinically important perioperative AF or MINS occurred in 360 patients in the colchicine group and in 415 patients in the placebo group . The composite outcome of vascular mortality, nonfatal MINS, nonfatal stroke or clinically important perioperative AF occurred in 364 patients in the colchicine group versus 422 in the placebo group . Six patients had a stroke, 1 in the colchicine group and 5 in the placebo group .
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