Colchicine prevents early postoperative pericardial and pleural effusions
American Heart Journal, 07/22/2011
Imazio M et al. – Colchicine is safe and efficacious for the primary prevention of postoperative effusions after cardiac surgery.Methods
- The COPPS is a multicenter, double–blind, randomized trial.
- 360 consecutive patients (mean age 65.7 ± 12.3 years, 66% men), 180 in each treatment arm, were randomized on the third postoperative day to receive placebo or colchicine for 1 month (1.0 mg twice daily for the first day, followed by a maintenance dose of 0.5 mg twice daily in patients ≥70 kg, and halved doses for patients <70 kg).
- The incidence of postoperative effusions was evaluated in each study group.
- Despite similar baseline features, colchicine significantly reduced the incidence of postoperative pericardial (12.8% vs 22.8%, P = .019, relative risk reduction 43.9%, no. of patients needed to treat 10) and pleural effusions (12.2% vs 25.6%, P = .002, relative risk reduction 52.3%, no. of patients needed to treat 8).
- The rate of side effects (only gastrointestinal intolerance) and drug withdrawal was similar in the study groups with a trend toward an increased rate of both events for colchicine.
- In multivariable analysis, female gender (hazard ratio 1.76, 95% CI 1.03–3.03, P = .040) and pleura incision (hazard ratio 2.58, 95% CI 1.53–4.53, P < .001) were risk factors for postoperative effusions.