2026-04-17T14:07:28Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/137462025-10-24T10:18:59Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
OFORI, SANDRA
author
Wang, Michael K.
author
Popova, Ekaterine
author
McIntyre, William F
author
Chan, Matthew
author
Sessler, Daniel
author
Gonzalez Tallada, Anna
2025-10-24T10:18:59Z
2025-10-24T10:18:59Z
2025-09-29T10:42:40Z2025-09-29T10:42:40Z2025-04
http://hdl.handle.net/11351/13746
Smoking; Colchicine; Thoracic surgeryTabaquisme; Colchicina; Cirurgia toràcicaTabaquismo; Colchicina; Cirugía torácicaBackground 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).
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess
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
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion