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Efficacy and Safety of Colchicine in Post–acute Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Diaz-Arocutipa, Carlos Benites-Meza, Jerry K. Chambergo-Michilot, Diego Barboza, Joshuan J. Pasupuleti, Vinay Bueno, Héctor Sambola Ayala, Antonia Institut Català de la Salut [Diaz-Arocutipa C] Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru. Programa de Atención Domiciliaria – EsSalud, Lima, Peru. [Benites-Meza JK] Tau Relaped Group, Trujillo, Peru. Facultad de Medicina, Universidad Nacional de Trujillo, Trujillo, Peru. [Chambergo-Michilot D] Tau Relaped Group, Trujillo, Peru. Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru. [Barboza JJ] Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru. Tau Relaped Group, Trujillo, Peru. [Pasupuleti V] MedErgy HealthGroup, Inc., Yardley, PA, United States. [Bueno H] Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain. Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain. Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain. [Sambola A] Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain. Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain Vall d'Hebron Barcelona Hospital Campus Infart de miocardi - Tractament Avaluació de resultats (Assistència sanitària) DISEASES::Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia::Myocardial Infarction Other subheadings::Other subheadings::Other subheadings::/drug therapy ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::isquemia miocárdica::infarto de miocardio Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento Colchicina; Inflamación; Infarto de miocardio Colquicina; Inflamació; Infart de miocardi Colchicine; Inflammation; Myocardial infarction Background: Inflammation plays a key role in atherosclerotic plaque destabilization and adverse cardiac remodeling. Recent evidence has shown a promising role of colchicine in patients with coronary artery disease. We evaluated the efficacy and safety of colchicine in post–acute myocardial infarction (MI) patients. Methods: We searched five electronic databases from inception to January 18, 2021, for randomized controlled trials (RCTs) evaluating colchicine in post–acute MI patients. Primary outcomes were cardiovascular mortality and recurrent MI. Secondary outcomes were all-cause mortality, stroke, urgent coronary revascularization, levels of follow-up high-sensitivity C-reactive protein (hs-CRP), and drug-related adverse events. All meta-analyses used inverse-variance random-effects models. Results: Six RCTs involving 6,005 patients were included. Colchicine did not significantly reduce cardiovascular mortality [risk ratio (RR), 0.91; 95% confidence interval (95% CI), 0.52–1.61; p = 0.64], recurrent MI (RR, 0.87; 95% CI, 0.62–1.22; p = 0.28), all-cause mortality (RR, 1.06; 95% CI, 0.61–1.85; p = 0.78), stroke (RR, 0.28; 95% CI, 0.07–1.09; p = 0.05), urgent coronary revascularization (RR, 0.46; 95% CI, 0.02–8.89; p = 0.19), or decreased levels of follow-up hs-CRP (mean difference, −1.95 mg/L; 95% CI, −12.88 to 8.98; p = 0.61) compared to the control group. There was no increase in any adverse events (RR, 0.97; 95% CI, 0.89–1.07; p = 0.34) or gastrointestinal adverse events (RR, 2.49; 95% CI, 0.48–12.99; p = 0.20). Subgroup analyses by colchicine dose (0.5 vs. 1 mg/day), time of follow-up (<1 vs. ≥1 year), and treatment duration (≤30 vs. >30 days) showed no changes in the overall findings. Conclusion: In post–acute MI patients, colchicine does not reduce cardiovascular or all-cause mortality, recurrent MI, or other cardiovascular outcomes. Also, colchicine did not increase drug-related adverse events. 2022-04-06T07:08:28Z 2022-04-06T07:08:28Z 2021-06 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Diaz-Arocutipa C, Benites-Meza JK, Chambergo-Michilot D, Barboza JJ, Pasupuleti V, Bueno H, et al. Efficacy and Safety of Colchicine in Post–acute Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Cardiovasc Med. 2021 Jun;8:676771. 2297-055X https://hdl.handle.net/11351/7309 10.3389/fcvm.2021.676771 34169101 000664073300001 http://hdl.handle.net/11351/7309 eng Frontiers in Cardiovascular Medicine;8 https://doi.org/10.3389/fcvm.2021.676771 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf application/pdf Frontiers Media Scientia