Colchicine Reduces Postsurgical Atrial Fibrillation Incidence

Colchicine, a drug often used to treat gout, greatly reduced the incidence of atrial fibrillation (AF) after heart surgery, according to a new study.

Researchers at Maria Vittoria Hospital (Turin, Italy) conducted a placebo-controlled, double blind, randomized study that included 336 heart surgery patients from six centers in northern Italy (average age 66, 69% male). Study participants were randomized to either 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 over 70 kg, and halved doses for patients under 70 kg) or to placebo, beginning three days after heart surgery and continuing for one month.

The results showed that one month after heart surgery, colchicine had cut the incidence of AF nearly in half; 12% of those taking colchicine suffered from AF, compared to 22% of patients given a placebo. Furthermore, colchicine patients were hospitalized three fewer days (21 versus 24) than those who received a placebo. Side effects were minimal and similar between the two groups, but colchicine patients were slightly more likely to experience gastrointestinal intolerance, the most common side effect. The study was published ahead of print on November 16, 2011, in Circulation.

“This is the first time that colchicine has been shown to prevent atrial fibrillation,” said lead author cardiologist Massimo Imazio, MD. “The findings are clinically significant and provide evidence that colchicine may represent a cheap, safe option for the prevention of the postpericardiotomy syndrome and postoperative AF.”

Colchicine is a plant-derived alkaloid. It is a toxic natural product and secondary metabolite, originally extracted from Colchicum autumnale, also known as "meadow saffron.” It was used originally to treat rheumatic complaints, especially gout, and still finds use for these purposes today despite dosing issues concerning its toxicity. Colchicine's present medicinal use is in the treatment of gout, familial Mediterranean fever (FMF), pericarditis, and Behçet's disease.

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