Use of Colchicine in the Prevention of Perioperative Atrial Fibrillation after Non-cardiac Thoracic Surgery

Post operative atrial fibrillation (AF) is one of the most frequent arrhythmias after noncardiac thoracic surgeries and is associated with markedly higher risk of stroke, myocardial infarction, and all-cause mortality. Colchicine, an anti-inflammatory drug may prevent post operative AF in patients who will undergo non-cardiac surgeries.

A systematic search of Cochrane, PubMed, ClinicalKey and Google Scholar was conducted for randomized controlled trials (RCTs) from inception until November 2023. The primary outcome was the incidence of peri-operative AF after any non-cardiac thoracic surgery. Risk ratios (RR) were reported using the Mantel Haenszel method.

A total of 3 RCTs with 3515 patients were eventually included in this meta-analysis, where 1760 patients received colchicine and 1755 patients received placebo or usual care. Perioperative colchicine treatment was related to a decreased incidence of post-operative AF (RR: 0.65; 95% confidence interval [CI]: 0.56 to 0.75, p<0.001).

In conclusion, the result of our meta-analysis suggests that colchicine treatment could lower the incidence of postoperative AF. Further studies are needed to determine the optimal colchicine treatment regimen to minimize the incidence of adverse events.