Tehran University Medical Journal (Jun 2014)
Low dose Colchicine in prevention of atrial fibrillation after coronary artery bypass graft: a double blind clinical trial
Abstract
Background: The occurrence of Atrial Fibrillation (AF) is linked to an increased inflam-matory response after cardiac surgery that is significantly decreased by anti-inflammatory treatments. The present study aimed at administrating Colchicine as a way to reduce the incidence of post- Coronary Artery Bypass Graft (CABG) atrial fibrillation. Methods: In this double-blind, parallel clinical trial, 216 patients with coronary artery disease who underwent CABG surgery, by using a table of random numbers are divided into intervention and control groups to receive placebo or Colchicine. The clinical and surgical characteristics of the patients in two groups were similar. The intervention group received 1.0 mg of Colchicine tab, the night before surgery and on the morning of surgery. This drug followed by 0.5 mg twice a day for five days after surgery. On the other hand patients in the control group received only placebo (ineffective pill with similar size to Colchicine). After operation two groups were compared regarding important outcomes such as postoperative arrhythmia, ICU stay and hospital stay. The data were assessed using SPSS software (version 17) and t-test and 2 statistical tests. Results: One hundred fifty six men and sixty women with a mean age of 59.9±9.3 years were enrolled in the study in two Colchicine and placebo groups (each consisting of 108 patients). The incidence of postoperative atrial fibrillation was 14.8% in the Col-chicine group and 30.6% in the control group (P= 0.006). ICU stay in the Colchicine group were 2.4±1.3 days versus 3.1±1.5 days in controls (P< 0.001) and hospital stay in the Colchicine group were 6.6±1.5 days versus 8.1±2.0 days in controls (P< 0.001). Conclusion: Colchicine is an anti-inflammatory medication and has very few side effects at low doses. According to the 48% reduction in the incidence of atrial fibrillation in Colchicine patients undergoing coronary artery bypass grafting surgery, this drug can be prescribed as a prophylaxis for prevention of post-CABG atrial fibrillation.
