Preoperative Colchicine Did Not Reduce Risk of Atrial fibrillation Interview with:
Ramzi Tabbalat, MD, FACC
Khalidi Hospital and Medical Center
Amman Jordan What is the background for this study? What are the main findings?

Dr. Tabbalat: Atrial fibrillation (AF) is the most common arrhythmia in patients undergoing open heart surgery. It occurs in about 26% of such patients and leads to increase morbidity and hospital cost. This makes prevention of AF a priority and several interventions have had variable success in this regards.

Colchicine, a potent anti-inflammatory agent, has shown promise in AF prevention in the COPPS-1 trial. Our study aimed to determine if colchicine administered preoperatively and continued until hospital discharge can prevent AF in post open heart surgery patients.

In our study of 360 patients, colchicine failed to significantly reduce the incidence of postoperative AF (RRR 29%, p=0.14). Its use was associated with significant diarrhea in 25% of patients. Diarrhea led to discontinuation of colchicine in more than half of affected patients. What should readers take away from your report?

Dr. Tabbalat: Colchicine cannot be recommended as a therapeutic or preventive option for postoperative AF. The results of our study parallel those of the COPPS-2 trial and, therefore, we believe that future guidelines will reflect that. What recommendations do you have for future research as a result of this study?

Dr. Tabbalat: I don’t think we will see more research looking at the role of colchicine for AF prevention. New research has shown that such patients do as well with measures to control the rate of AF rather than attempt to revert AF to sinus rhythm. Having said that I believe there may still be room for research testing a lower dose of colchicine on a larger cohort where we may see significant benefit without the appearance of severe diarrhea. Is there anything else you would like to add?

Dr. Tabbalat: I would like to add that although our trial was a negative one, such trials are important in medicine especially when they deal with relatively common issues where doctors are accustomed to certain ways of treatment. I know cardiologists and cardiac surgeons who have been using colchicine on their patients with the assumption that it works. Now they know that it does not and hopefully will stop using colchicine for this purpose. Thank you for your contribution to the community.


Effect of ColchiciNe on the InciDence of Atrial Fibrillation in Open Heart Surgery Patients: END-AF Trial
Tabbalat, Ramzi A. et al.
American Heart Journal
DOI: May 17, 2016

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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2 thoughts on “Preoperative Colchicine Did Not Reduce Risk of Atrial fibrillation

  1. Demise of colchicine to prevent AF in cardiac surgery patients. I am honored to be an investigator in this study. As we reported the follow up to the primary investigator, we thought there was a positive effect.. as more cases were enrolled, we realized that AF is defiant to colchicine.
    A. Hammoudeh, MD, FACC

  2. This is an extremely intersting study, and the results will definitely improve medical practice.
    Thank you for sharing and my regards to Dr. Tabbalat for his effrorts!

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