title: Colchicine prevents early postoperative pericardial and pleural effusions.
abstract: BACKGROUND
  No preventive pharmacologic strategies have been proven efficacious for the prevention of postoperative effusions after cardiac surgery. Colchicine is safe and efficacious for the prevention of pericarditis. On this basis, we realized a substudy of the COPPS trial to assess the efficacy and safety of colchicine for the prevention of postoperative pericardial and pleural effusions.
  
  
  METHODS
  The COPPS is a multicenter, double-blind, randomized trial, where 360 consecutive patients (mean age 65.7 ± 12.3 years, 66% men), 180 in each treatment arm, were randomized on the third postoperative day to receive placebo or colchicine for 1 month (1.0 mg twice daily for the first day, followed by a maintenance dose of 0.5 mg twice daily in patients ≥70 kg, and halved doses for patients <70 kg). The incidence of postoperative effusions was evaluated in each study group.
  
  
  RESULTS
  Despite similar baseline features, colchicine significantly reduced the incidence of postoperative pericardial (12.8% vs 22.8%, P = .019, relative risk reduction 43.9%, no. of patients needed to treat 10) and pleural effusions (12.2% vs 25.6%, P = .002, relative risk reduction 52.3%, no. of patients needed to treat 8). The rate of side effects (only gastrointestinal intolerance) and drug withdrawal was similar in the study groups with a trend toward an increased rate of both events for colchicine. In multivariable analysis, female gender (hazard ratio 1.76, 95% CI 1.03-3.03, P = .040) and pleura incision (hazard ratio 2.58, 95% CI 1.53-4.53, P < .001) were risk factors for postoperative effusions.
  
  
  CONCLUSIONS
  Colchicine is safe and efficacious for the primary prevention of postoperative effusions after cardiac surgery.
authors: Cardiology Department, Maria Vittoria Hospital, Torino, Italy. massimo_imazio@yahoo.it
authors: Massimo
authors: M
authors: Imazio
authors: Antonio
authors: A
authors: Brucato
authors: Maria Elena
authors: ME
authors: Rovere
authors: Anna
authors: A
authors: Gandino
authors: Roberto
authors: R
authors: Cemin
authors: Stefania
authors: S
authors: Ferrua
authors: Silvia
authors: S
authors: Maestroni
authors: Edoardo
authors: E
authors: Zingarelli
authors: Alberto
authors: A
authors: Barosi
authors: Caterina
authors: C
authors: Simon
authors: Fabrizio
authors: F
authors: Sansone
authors: Davide
authors: D
authors: Patrini
authors: Ettore
authors: E
authors: Vitali
authors: Riccardo
authors: R
authors: Belli
authors: Paolo
authors: P
authors: Ferrazzi
authors: Rita
authors: R
authors: Trinchero
authors: David H
authors: DH
authors: Spodick
authors: Yehuda
authors: Y
authors: Adler
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003078:Colchicine / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000601:surgery; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D010490:Pericardial Effusion / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D010996:Pleural Effusion / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D050257:Tubulin Modulators; D003078:Colchicine