title: Colchicine reduces postoperative atrial fibrillation: results of the Colchicine for the Prevention of the Postpericardiotomy Syndrome (COPPS) atrial fibrillation substudy.
abstract: BACKGROUND
  Inflammation and pericarditis may be contributing factors for postoperative atrial fibrillation (POAF), and both are potentially affected by antiinflammatory drugs and colchicine, which has been shown to be safe and efficacious for the prevention of pericarditis and the postpericardiotomy syndrome (PPS). The aim of the Colchicine for the Prevention of the Post-Pericardiotomy Syndrome (COPPS) POAF substudy was to test the efficacy and safety of colchicine for the prevention of POAF after cardiac surgery.
  
  
  RESULTS
  The COPPS POAF substudy included 336 patients (mean age, 65.7±12.3 years; 69% male) of the COPPS trial, a multicenter, double-blind, randomized trial. Substudy patients were in sinus rhythm before starting the intervention (placebo/colchicine 1.0 mg twice daily starting on postoperative day 3 followed by a maintenance dose of 0.5 mg twice daily for 1 month in patients ≥70 kg, halved doses for patients <70 kg or intolerant to the highest dose). The substudy primary end point was the incidence of POAF on intervention at 1 month. Despite well-balanced baseline characteristics, patients on colchicine had a reduced incidence of POAF (12.0% versus 22.0%, respectively; P=0.021; relative risk reduction, 45%; number needed to treat, 11) with a shorter in-hospital stay (9.4±3.7 versus 10.3±4.3 days; P=0.040) and rehabilitation stay (12.1±6.1 versus 13.9±6.5 days; P=0.009). Side effects were similar in the study groups.
  
  
  CONCLUSIONS
  Colchicine seems safe and efficacious in the reduction of POAF with the potentiality of halving the complication and reducing the hospital stay.
authors.affiliation: Cardiology Department, Maria Vittoria Hospital, Via Cibrario 72, Turin, Italy. massimo_imazio@yahoo.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Imazio
authors.forename: Antonio
authors.initials: A
authors.lastname: Brucato
authors.forename: Paolo
authors.initials: P
authors.lastname: Ferrazzi
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Rovere
authors.forename: Anna
authors.initials: A
authors.lastname: Gandino
authors.forename: Roberto
authors.initials: R
authors.lastname: Cemin
authors.forename: Stefania
authors.initials: S
authors.lastname: Ferrua
authors.forename: Riccardo
authors.initials: R
authors.lastname: Belli
authors.forename: Silvia
authors.initials: S
authors.lastname: Maestroni
authors.forename: Caterina
authors.initials: C
authors.lastname: Simon
authors.forename: Edoardo
authors.initials: E
authors.lastname: Zingarelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Barosi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Sansone
authors.forename: Davide
authors.initials: D
authors.lastname: Patrini
authors.forename: Ettore
authors.initials: E
authors.lastname: Vitali
authors.forename: Rita
authors.initials: R
authors.lastname: Trinchero
authors.forename: David H
authors.initials: DH
authors.lastname: Spodick
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Adler
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures; D003078:Colchicine / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D003078:Colchicine