Colchicine for stroke prevention in patients with coronary artery disease: a systematic review and meta‐analysis
Aristeidis H. Katsanos, Lina Palaiodimou, Christopher Price, Sotirios Giannopoulos, Robin Lemmens, Maria Kosmidou, Marios K. Georgakis, Christian Weimar, Peter J. Kelly, Georgios Tsivgoulis
Abstract
Background and purpose Although clinical trials suggest that colchicine may reduce the risk of vascular events in patients with a history of coronary artery disease, its effect on the prevention of cerebrovascular events still remains unclear. Methods A systematic review and meta‐analysis was performed of all available randomized controlled trials (RCTs) reporting on incident strokes during the follow‐up of patients with a history of cardiovascular disease randomized to colchicine treatment or control (placebo or usual care). Results Four RCTs were identified, including a total of 5553 patients (mean age 61 years, 81% males), with a follow‐up ranging from 1 to 36 months. Colchicine treatment was associated with a significantly lower risk of incident stroke during follow‐up compared to control (risk ratio 0.31, 95% confidence interval 0.13–0.71), without heterogeneity across included studies ( I 2 = 0%). Based on the pooled incident stroke rate of control groups (0.9%) in the included RCTs, it was estimated that administration of low‐dose colchicine to 161 patients with coronary artery disease would prevent one stroke during a follow‐up of 23 months. Conclusion Colchicine treatment decreases stroke risk in patients with a history of coronary artery disease. The effect of colchicine in secondary stroke prevention is currently being evaluated in an ongoing RCT.