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Colchicine for prevention of early atrial fibrillation recurrence after pulmonary vein isolation: a randomized controlled study.

Abstract：

OBJECTIVES:The purpose of the present study was to test the potential of colchicine, an agent with potent anti-inflammatory action, to reduce atrial fibrillation (AF) recurrence after pulmonary vein isolation in patients with paroxysmal AF. BACKGROUND:Proinflammatory processes induced by AF ablation therapy have been implicated in postablation arrhythmia recurrence. METHODS:Patients with paroxysmal AF who received radiofrequency ablation treatment were randomized to a 3-month course of colchicine 0.5 mg twice daily or placebo. C-reactive protein (CRP) and interleukin (IL)-6 levels were measured on day 1 and on day 4 of treatment. RESULTS:In the 3-month follow-up, recurrence of AF was observed in 27 (33.5%) of 80 patients of the placebo group versus 13 (16%) of 81 patients who received colchicine (odds ratio: 0.38, 95% confidence interval: 0.18 to 0.80). Gastrointestinal side-effects were the most common symptom among patients receiving active treatment. Diarrhea was reported in 7 patients in the colchicine group (8.6%) versus 1 in the placebo group (1.3%, p = 0.03). Colchicine led to higher reductions in CRP and IL-6 levels: the median difference of CRP and IL-6 levels between days 4 and 1 was -0.46 mg/l (interquartile range: -0.78 to 0.08 mg/l) and -0.10 mg/l (-0.30 to 0.10 pg/ml), respectively, in the placebo group versus -1.18 mg/l (-2.35 to -0.46 mg/l) and -0.50 pg/ml (-1.15 to -0.10 pg/ml) in the colchicine group (p < 0.01 for both comparisons). CONCLUSIONS:Colchicine is an effective and safe treatment for prevention of early AF recurrences after pulmonary vein isolation in the absence of antiarrhythmic drug treatment. This effect seems to be associated strongly with a significant decrease in inflammatory mediators, including IL-6 and CRP.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Deftereos S,Giannopoulos G,Kossyvakis C,Efremidis M,Panagopoulou V,Kaoukis A,Raisakis K,Bouras G,Angelidis C,Theodorakis A,Driva M,Doudoumis K,Pyrgakis V,Stefanadis C

doi

10.1016/j.jacc.2012.07.031

subject

Has Abstract

pub_date

2012-10-30 00:00:00

pages

1790-6

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(12)03033-1

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Colchicine for prevention of early atrial fibrillation recurrence after pulmonary vein isolation: a randomized controlled study.