Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Cardiology-CTVS
  • Cardiology & CTVS News
  • ESC 2023 Update:...

ESC 2023 Update: Colchicine does not reduce primary outcomes in patients undergoing major non-cardiac thoracic surgery: COP-AF trial

Written By : Dr. Kamal Kant Kohli Published On 2023-08-28T10:30:15+05:30  |  Updated On 26 Oct 2023 5:18 PM IST
ESC 2023 Update: Colchicine does not reduce primary outcomes in patients undergoing major non-cardiac thoracic surgery: COP-AF trial
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

Canada: In patients undergoing major non-cardiac thoracic surgery, colchicine fails to significantly reduce perioperative atrial fibrillation (AF) or myocardial injury after non-cardiac surgery (MINS), COP-AF trial has shown.

The findings were presented in a Hot Line session on August 26 at ESC (European Society of Cardiology) Congress 2023.

Perioperative AF occurs in approximately 10% of patients after major thoracic surgery, while MINS has an incidence of about 20% in the same patient population. Patients with perioperative AF and MINS have a poor prognosis. High levels of inflammatory biomarkers have been associated with an increased risk of perioperative AF and MINS. Anti-inflaEuropean Society of Cardiologymmatory treatment therefore has the potential to reduce the incidence of these two prognostically important complications. Colchicine is an inexpensive drug with anti-inflammatory effects. Small randomised trials have suggested that in patients undergoing cardiac surgery, low-dose colchicine reduces the risk of perioperative AF. Two large randomised trials found that low-dose colchicine significantly reduced the incidence of major cardiovascular outcomes in patients with coronary artery disease.

The COP-AF trial tested the hypothesis that colchicine reduces the incidence of clinically important perioperative AF and MINS in patients undergoing major non-cardiac thoracic surgery. The trial enrolled patients aged 55 years or older who were undergoing major non-cardiac thoracic surgery. Participants were randomly assigned in a 1:1 ratio to receive oral colchicine 0.5mg twice daily or a matching placebo, starting within four hours before surgery and for a total duration of 10 days. Two co-primary outcomes were assessed during 14 days of follow-up: 1) clinically important perioperative AF (i.e., AF needing medical treatment or AF leading to heart failure, hypotension or angina) and 2) MINS (i.e., myocardial infarction or any postoperative troponin elevation deemed to be of ischaemic origin).

The study included 3,209 patients from 45 sites in 11 countries. The mean age was 68 years and 48.4% were women. Clinically important AF developed in 103 of 1,608 (6.4%) patients assigned to colchicine and 120 of 1,601 (7.5%) patients assigned to placebo, for a hazard ratio (HR) of 0.85 (95% confidence interval [CI] 0.65 to 1.10) and absolute risk reduction (ARR) of 1.1% (95% CI -0.7 to 2.8, p=0.22). MINS occurred in 295 (18.3%) patients assigned to colchicine and 325 (20.3%) patients assigned to placebo, HR 0.89 (95% CI 0.76 to 1.05) and ARR 2.0% (95% CI -0.8 to 4.7, p=0.16).

There were no significant differences between treatment groups in key secondary outcomes, including the composite of all-cause mortality, nonfatal MINS and nonfatal stroke, HR 0.88 (95% CI 0.75 to 1.03); the composite of all-cause mortality, nonfatal myocardial infarction (MI) and nonfatal stroke, HR 0.67 (95% CI 0.39 to 1.17); MINS not fulfilling the fourth universal definition of MI, HR 0.90 (95% CI 0.76 to 1.06); and MI, HR 0.86 (95% CI 0.41 to 1.81).

In post-hoc analyses, the composite outcome of clinically important perioperative AF or MINS occurred in 360 (22.4%) patients in the colchicine group and in 415 (25.9%) patients in the placebo group (HR 0.84; 95% CI 0.73 to 0.97). The composite outcome of vascular mortality, nonfatal MINS, nonfatal stroke or clinically important perioperative AF occurred in 364 (22.6%) patients in the colchicine group versus 422 (26.4%) in the placebo group (HR 0.83; 95% CI, 0.72 to 0.96). Six patients had a stroke, 1 (0.1%) in the colchicine group and 5 (0.3%) in the placebo group (p=0.12).

From a safety perspective, the composite outcome of sepsis or infection occurred in 103 (6.4%) patients in the colchicine group and 83 (5.2%) patients in the placebo group (HR 1.24; 95% CI 0.93 to 1.66). Colchicine increased the incidence of non-infectious diarrhoea, 134 (8.3%) versus 38 (2.4%) patients, HR 3.64 (95% CI 2.54 to 5.22). No treatment was required in 66 (38.4%) cases of diarrhoea, 15 (8.7%) patients needed intravenous hydration, 2 (1.2%) received antibiotics, and 1 (0.7%) patient required readmission for diarrhoea. In the colchicine group, the median (interquartile range) length of stay was 5 (4-7) days in patients with diarrhoea and 5 (3-7) days in those without diarrhoea.

Principal investigator Dr. David Conen of the Population Health Research Institute, Hamilton, Canada said: “Colchicine did not significantly reduce the incidence of the co-primary outcomes of clinically important perioperative AF or MINS. Colchicine increased the risk of non-infectious diarrhoea, but our data suggest that these episodes were temporary and benign. Despite these findings, several results provide an encouraging signal of benefit for colchicine to reduce the incidence of adverse cardiovascular outcomes in patients undergoing major non-cardiac thoracic surgery. Future trials should further investigate the role of colchicine in the prevention of these events in patients undergoing surgery.”

European Society of CardiologyColchicineatrial fibrillationmyocardial injurymajor thoracic surgerycoronary artery disease
Dr. Kamal Kant Kohli
Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

Show Full Article
Next Story

Editorial

Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

Relevance of Pioglitazone in Indian T2DM Care Continuum

Relevance of Pioglitazone in Indian T2DM Care Continuum

Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

First Indian Consensus on Managing Refractory Gastroesophageal Reflux Disease Recommends Vonoprazan

First Indian Consensus on Managing Refractory Gastroesophageal Reflux Disease Recommends Vonoprazan

View All

Journal Club Today

Global Omega-3 Shortage Poses Serious Health and Environmental Risks: Study

Global Omega-3 Shortage Poses Serious Health and Environmental Risks: Study

View All

Health News Today

Health Bulletin 31/May/2025

Health Bulletin 31/May/2025

View All
© 2022 All Rights Reserved.
Powered By: Hocalwire
X
We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok