2026-04-17T17:26:56Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/137462025-10-24T10:18:59Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc OFORI, SANDRA author Wang, Michael K. author Popova, Ekaterine author McIntyre, William F author Chan, Matthew author Sessler, Daniel author Gonzalez Tallada, Anna author 2025-09-29T10:42:40Z 2025-09-29T10:42:40Z 2025-04 Smoking; Colchicine; Thoracic surgery Tabaquisme; Colchicina; Cirurgia toràcica Tabaquismo; Colchicina; Cirugía torácica Background To determine, among patients who underwent major noncardiac thoracic surgery, the association between smoking and perioperative atrial fibrillation (AF) and myocardial injury after noncardiac surgery (MINS), and whether the effect of colchicine use on these outcomes varied by smoking status. Methods This study is a subgroup analysis of the Colchicine for the Prevention of Perioperative Atrial Fibrillation (COP-AF) randomized clinical trial. A total of 3209 participants who underwent major noncardiac thoracic surgery were randomized to receive colchicine, 0.5 mg twice daily, or identical placebo, for 10 days starting 2-4 hours before surgery. The co-primary outcomes were clinically significant perioperative AF and MINS during the 14-day follow-up. Results A total of 687 (21.4%) were current smokers, 1577 (49.1%) were former smokers, and 945 (29.5%) were never smokers. AF occurred in 7.7%, 7.6%, and 5.3%, and MINS occurred in 21.0%, 19.7%, and 17.6% of current, former, and never smokers, respectively. Compared to never smokers, the adjusted hazard ratio for AF was 1.72 (95% confidence interval [CI] 1.07-2.77, P = 0.02) in current smokers and 1.46 (95% CI 0.99-2.16, P = 0.06) in former smokers, and the adjusted hazard ratio for MINS was 1.16 (95% CI 0.87-1.54, P = 0.32) in current smokers and 1.02 (95% CI 0.81-1.28, P = 0.88) in former smokers. No interaction occurred between smoking status and colchicine allocation for AF (interaction P, 0.82) or MINS (interaction P, 0.08). Conclusions Current smoking was associated with a small but increased risk of perioperative AF but not MINS after thoracic surgery. The effect of colchicine use on either outcome was not modified by smoking status. Clinical Trial Registration NCT03310125. This post hoc analysis did not receive specific funding. However, the main COP-AF trial was supported by the following: Canadian Institutes of Health Research (PJT-162458, PJT-165842); Accelerating Clinical Trials Consortium; Innovation Fund of the Alternative Funding Plan for the Academic Health Sciences Centres of Ontario; Population Health Research Institute; Hamilton Health Sciences; Division of Cardiology at McMaster University, Canada; Hanela Foundation, Switzerland; and General Research Fund (14121720), Research Grants Council, Hong Kong (14121720). http://hdl.handle.net/11351/13746 Avaluació de resultats (Assistència sanitària) Tabaquisme Tòrax - Cirurgia Fibril·lació auricular CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Mitosis Modulators::Antimitotic Agents Other subheadings::Other subheadings::/therapeutic use DISCIPLINES AND OCCUPATIONS::Health Occupations::Medicine::Specialties, Surgical::Thoracic Surgery PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Behavior::Smoking ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome DISEASES::Cardiovascular Diseases::Heart Diseases::Arrhythmias, Cardiac::Atrial Fibrillation COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::mecanismos moleculares de acción farmacológica::moduladores de la mitosis::antimitóticos Otros calificadores::Otros calificadores::/uso terapéutico DISCIPLINAS Y OCUPACIONES::profesiones sanitarias::medicina::especialidades quirúrgicas::cirugía torácica PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::conducta::fumar TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas::fibrilación atrial Smoking, Colchicine and Postoperative Outcomes in Thoracic Surgery: Post Hoc Analysis of the COP-AF Randomized Controlled Trial