Usefulness of colchicine to reduce perioperative myocardial damage in patients
who underwent on-pump coronary artery bypass grafting.
Author(s): Giannopoulos G(1), Angelidis C(2), Kouritas VK(3), Dedeilias P(3), Filippatos
G(4), Cleman MW(5), Panagopoulou V(6), Siasos G(6), Tousoulis D(6), Lekakis J(4),
Deftereos S(7).
Affiliation(s): Author information:
(1)Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens,
Greece; Section of Cardiovascular Medicine, Yale University School of Medicine,
New Haven, Connecticut. Electronic address: ggiann@med.uoa.gr. (2)Department of
Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece.
(3)Department of Cardiac Surgery, Evangelismos General Hospital, Athens, Greece.
(4)Second Department of Cardiology, University of Athens Medical School, Attikon
Hospital, Athens, Greece. (5)Section of Cardiovascular Medicine, Yale University
School of Medicine, New Haven, Connecticut. (6)First Department of Cardiology,
University of Athens Medical School, Hippokration Hospital, Athens, Greece.
(7)Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens,
Greece; Section of Cardiovascular Medicine, Yale University School of Medicine,
New Haven, Connecticut.
Publication date & source: 2015, Am J Cardiol. , 115(10):1376-81
The objective of the present study was to test whether a perioperative course of
colchicine, in patients who underwent standard coronary artery bypass grafting,
would result in reduced postoperative increase of myocardial injury biomarker
levels. Patients were prospectively randomized to colchicine or placebo starting
48 hours before scheduled coronary artery bypass grafting and for 8 days
thereafter (0.5 mg twice daily). The primary outcome parameter was maximal
high-sensitivity troponin T (hsTnT) concentration within 48 hours after surgery.
Secondary outcome measures were maximal creatine kinase-myocardial brain fraction
(CK-MB) levels and area under the curve (AUC) of hsTnT and CK-MB concentrations;
59 patients were included. Maximal hsTnT was 616 pg/ml (396 to 986) in the
colchicine group versus 1,613 pg/ml (732 to 2,587) in controls (p = 0.002).
Maximal CK-MB was 44.6 ng/ml (36.6 to 68.8) and 93.0 ng/ml (48.0 to 182.3),
respectively (p = 0.002). The median AUC for hsTnT was 40,755 pg h/ml (20,868 to
79,176) in controls versus 20,363 pg h/ml (13,891 to 31,661) in the colchicine
group (p = 0.002). AUCs for CK-MB were 2,552 ng h/ml (1,564 to 4,791) in controls
and 1,586 ng h/ml (1,159 to 2,073) in the colchicine group (p = 0.003). The main
complaints associated with colchicine were, as expected, gastrointestinal, with 5
patients (16.7%) in the colchicine group reporting diarrhea versus 1 control
(3.4%) (p = 0.195). In conclusion, a short perioperative course of colchicine was
effective in attenuating postoperative increases of hsTnT and CK-MB compared with
placebo. This finding, which needs confirmation in a larger clinical trial
powered to assess clinical endpoints, suggests a potential role for this agent in
reducing cardiac surgery-related myocardial damage.
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