Περίληψη:
The objective of the present study was to test whether a perioperative
course of colchicine, in patients who underwent standard coronary artery
bypass grafting, would result in reduced postoperative increase of
myocardial injury biomarker levels. Patients were prospectively
randomized to colchicine or placebo starting 48 hours before scheduled
coronary artery bypass grafting and for 8 days thereafter (0.5 mg twice
daily). The primary outcome parameter was maximal high-sensitivity
troponin T (hsTnT) concentration within 48 hours after surgery.
Secondary outcome measures were maximal creatine kinase-myocardial brain
fraction (CK-MB) levels and area under the curve (AUC) of hsTnT and
CK-MB concentrations; 59 patients were included. Maximal hsTnT was 616
pg/ml (396,to 986) in the colchicine group versus 1,613 pg/ml (732 to
2,587) in controls (p = 0.002). Maximal CK-MB was 44:6 ng/ml (36.6 to
68.8) and 93.0 ng/ml (48.0 to 182.3), respectively (p = 0.002). The
median AUC for hsTnT was 40,755 pg h/ml (20,868 to 79,176) in controls
versus 20,363 pg h/ml (13,891 to 31,661) in the colchicine group (p =
0.002). AUCs for CK-M13 were 2,552 ng h/ml (1,564 to 4,791) in controls
and 1,586 ng h/ml (1,159 to 2,073) in the colchicine group (p = 0.003).
The main complaints associated with colchicine were, as expected,
gastrointestinal, with 5 patients (16.7%) in the colchicine group
reporting diarrhea versus 1 control (3.4%) (p = 0.195). In conclusion,
a short perioperative course of colchicine was effective in attenuating
postoperative increases of hsTnT and CK-MB compared with placebo. This
finding, which needs confirmation in a larger clinical trial powered to
assess clinical endpoints, suggests a potential role for this agent in
reducing cardiac surgery related myocardial damage. (C) 2015 Elsevier
Inc. All rights reserved.
Συγγραφείς:
Giannopoulos, Georgios
Angelidis, Christos
Kouritas, Vasileios
K.
Dedeilias, Panagiotis
Filippatos, Gerasimos
Cleman,
Michael W.
Panagopoulou, Vasiliki
Siasos, Gerasimos and
Tousoulis, Dimitrios
Lekakis, John
Deftereos, Spyridon
