Τίτλος:
Colchicine for Prevention of Early Atrial Fibrillation Recurrence After
Pulmonary Vein Isolation A Randomized Controlled Study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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. (J Am Coll Cardiol 2012;60:1790-6) (C) 2012 by
the American College of Cardiology Foundation
Συγγραφείς:
Deftereos, Spyridon
Giannopoulos, Georgios
Kossyvakis,
Charalambos
Efremidis, Michael
Panagopoulou, Vasiliki and
Kaoukis, Andreas
Raisakis, Konstantinos
Bouras, Georgios and
Angelidis, Christos
Theodorakis, Andreas
Driva, Metaxia and
Doudoumis, Konstantinos
Pyrgakis, Vlasios
Stefanadis,
Christodoulos
Περιοδικό:
Journal of the American College of Cardiology
Εκδότης:
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Λέξεις-κλειδιά:
ablation; atrial fibrillation; colchicine; C-reactive protein;
inflammation; interleukin-6; radiofrequency
DOI:
10.1016/j.jacc.2012.07.031
