According to research published early online in Circulation, colchicine appears to be safe and efficacious in the reduction of postoperative atrial fibrillation (POAF) after cardiac surgery.

The aim of the Colchicine for the Prevention of the Post-Pericardiotomy Syndrome (COPPS) POAF randomised trial was to test the efficacy and safety of colchicine for the prevention of POAF in 336 patients undergoing cardiac surgery. Patients included were in sinus rhythm at the start of treatment and were randomised to receive either placebo or colchicine 1.0 mg twice daily starting on postoperative day 3 followed by a maintenance dose of 0.5 mg twice daily for 1 month in patients over 70kg, or 0.25mg twice daily for patients <70 kg or intolerant to the highest dose.  The primary endpoint was the incidence of POAF on intervention at 1 month.

The researchers reported that patients on colchicine had a reduced incidence of POAF compared to placebo (12.0% versus 22.0%, respectively; P=0.021; relative risk reduction, 45%; number needed to treat, 11) with a shorter in-hospital stay (9.4±3.7 versus 10.3±4.3 days; P=0.040) and rehabilitation stay (12.1±6.1 versus 13.9±6.5 days; P=0.009). Additionally, side effects were similar in the study groups.

The researchers conclude that results from this study may impact clinical practice because colchicine might represent a cheap and relatively safe option for the prevention of both PPS and POAF, both common and troublesome complications of cardiac surgery that may increase management costs