Colchicine for Stroke Prevention in Patients with Coronary Artery Disease: A Systematic Review and Meta-analysis.

Although clinical trials suggest that colchicine may reduce risk of vascular events in patients with a history of coronary artery disease, its effect on the prevention of cerebrovascular events still remains unclear.We performed a systematic review and meta-analysis of all available to date randomized-controlled clinical trials (RCTs) reporting on incident strokes during the follow-up of patients with history of cardiovascular disease randomized to colchicine treatment or control (placebo or usual care).

We identified 4 RCTs, including a total of 5553 patients (mean age 61 years, 81% males), with a follow-up ranging from 1 to 36 months. Colchicine treatment was associated with a significantly lower risk of incident stroke during follow-up compared to control (Risk Ratio=0.31,95% confidence interval: 0.13-0.71), without heterogeneity across included studies (I² =0%). Based on the pooled incident stroke rate of control groups (0.9%) in the included RCTs, we estimate that administration of low dose colchicine to 161 patients with coronary artery disease would prevent one stroke during a follow-up of 23 months.

Colchicine treatment decreases stroke risk in patients with history of coronary artery disease. The effect of colchicine in secondary stroke prevention is currently being evaluated in an ongoing RCT.