An Updated Meta-Analysis of RCTs of Colchicine for Stroke Prevention in Patients with Coronary Artery Disease

Katsanos, Aristeidis H.; Palaiodimou, Lina; Price, Christopher; Themistocleous, Marios; Lemmens, Robin; Michopoulos, Ioannis; Georgakis, Marios K.; Weimar, Christian; Kelly, Peter; Tsivgoulis, Georgios

doi:10.3390/jcm10143110

Open AccessArticle

An Updated Meta-Analysis of RCTs of Colchicine for Stroke Prevention in Patients with Coronary Artery Disease

by

Aristeidis H. Katsanos

^1,*

,

Lina Palaiodimou

²

,

Christopher Price

³,

Marios Themistocleous

⁴,

Robin Lemmens

^5,6,7,

Ioannis Michopoulos

⁸,

Marios K. Georgakis

⁹,

Christian Weimar

^10,11,

Peter Kelly

¹² and

Georgios Tsivgoulis

^2,13

¹

Division of Neurology, Population Health Research Institute & McMaster University, Hamilton, ON L8S 4L8, Canada

²

Second Department of Neurology, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, 45701 Athens, Greece

³

Population Health Sciences Institute, Newcastle University, Newcastle NE1 7RU, UK

⁴

Department of Neurosurgery, Pediatric Hospital of Athens, 45701 Athens, Greece

⁵

Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), KU Leuven—University of Leuven, B-3000 Leuven, Belgium

⁶

Center for Brain and Disease Research, Laboratory of Neurobiology, VIB, B-3000 Leuven, Belgium

⁷

Department of Neurology, University Hospitals Leuven, B-3000 Leuven, Belgium

⁸

Second Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, “Attikon” General Hospital, 45701 Athens, Greece

⁹

Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-University, 81377 Munich, Germany

¹⁰

Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, 47057 Duisburg, Germany

¹¹

BDH-Clinic Elzach, 79215 Elzach, Germany

¹²

Health Research Board Stroke Clinical Trials Network Ireland and Mater University Hospital, University College Dublin, D04 V1W8 Dublin, Ireland

¹³

Department of Neurology, University of Tennessee Health Science Center, Memphis, TN 38103, USA

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^*

Author to whom correspondence should be addressed.

J. Clin. Med. 2021, 10(14), 3110; https://doi.org/10.3390/jcm10143110

Submission received: 18 June 2021 / Revised: 10 July 2021 / Accepted: 12 July 2021 / Published: 14 July 2021

(This article belongs to the Special Issue Stroke Management - Diagnostic and Therapy)

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Abstract

Emerging evidence from randomized controlled clinical trials (RCTs) suggests that colchicine has cardiovascular benefits for patients with coronary disease, including benefits for stroke prevention. We performed an updated systematic review and meta-analysis of all RCTs reporting on stroke outcomes during the follow-up of patients with a history of cardiovascular disease randomized to colchicine treatment or control (placebo or usual care). We identified 6 RCTs including a total of 11,870 patients (mean age 63 years, 83% males) with a mean follow-up of 2 years. Colchicine treatment was associated with a lower risk of stroke during follow-up, compared to that of placebo or usual care (risk ratio = 0.49, 95% confidence interval: 0.31–0.80; p = 0.004), without heterogeneity across the included studies (I² = 0%, p for Cochran’s Q = 0.52). In the subgroup analysis, no heterogeneity (p = 0.77) was identified in the effect of colchicine on stroke prevention between patients with recent acute (RR = 0.55, 95% CI: 0.15–2.05) or chronic stable (RR = 0.43, 95% CI: 0.21–0.89) coronary artery syndromes. In conclusion, we found that colchicine treatment decreases the stroke risk in patients with a history of atherosclerotic cardiovascular disease.

Keywords: stroke; colchicine; coronary artery disease; prevention

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MDPI and ACS Style

Katsanos, A.H.; Palaiodimou, L.; Price, C.; Themistocleous, M.; Lemmens, R.; Michopoulos, I.; Georgakis, M.K.; Weimar, C.; Kelly, P.; Tsivgoulis, G. An Updated Meta-Analysis of RCTs of Colchicine for Stroke Prevention in Patients with Coronary Artery Disease. J. Clin. Med. 2021, 10, 3110. https://doi.org/10.3390/jcm10143110

AMA Style

Katsanos AH, Palaiodimou L, Price C, Themistocleous M, Lemmens R, Michopoulos I, Georgakis MK, Weimar C, Kelly P, Tsivgoulis G. An Updated Meta-Analysis of RCTs of Colchicine for Stroke Prevention in Patients with Coronary Artery Disease. Journal of Clinical Medicine. 2021; 10(14):3110. https://doi.org/10.3390/jcm10143110

Chicago/Turabian Style

Katsanos, Aristeidis H., Lina Palaiodimou, Christopher Price, Marios Themistocleous, Robin Lemmens, Ioannis Michopoulos, Marios K. Georgakis, Christian Weimar, Peter Kelly, and Georgios Tsivgoulis. 2021. "An Updated Meta-Analysis of RCTs of Colchicine for Stroke Prevention in Patients with Coronary Artery Disease" Journal of Clinical Medicine 10, no. 14: 3110. https://doi.org/10.3390/jcm10143110

APA Style

Katsanos, A. H., Palaiodimou, L., Price, C., Themistocleous, M., Lemmens, R., Michopoulos, I., Georgakis, M. K., Weimar, C., Kelly, P., & Tsivgoulis, G. (2021). An Updated Meta-Analysis of RCTs of Colchicine for Stroke Prevention in Patients with Coronary Artery Disease. Journal of Clinical Medicine, 10(14), 3110. https://doi.org/10.3390/jcm10143110

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An Updated Meta-Analysis of RCTs of Colchicine for Stroke Prevention in Patients with Coronary Artery Disease

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