Journal of the American Heart Association · 2025
Preoperative Colchicine and Conduction Disturbances After Transcatheter Aortic Valve Implantation: A US Retrospective Cohort Analysis.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Abdelsayed Kerollos, Amer Basma Ehab, Almahdy Mohamed Ahmed, Fouad Michele, Amin Ahmed Mazen, Ibrahim Mahmoud Mahmoud, Thangjui Sittinun, Abdelazeem Basel, Balla Sudarshan, Latib Azeem
Аннотация
BACKGROUND: Conduction disturbances are frequent complications following transcatheter aortic valve intervention (TAVI), partially driven by inflammation. The anti-inflammatory role of colchicine on these disorders post TAVI has not been studied yet. Therefore, we investigated the association between preoperative colchicine use and conduction disturbances after TAVI.
METHODS: We used the TriNetX platform, a data repository of health record data from health care organizations in the United States, to identify patients receiving any colchicine prescription within 3 months before their first TAVI and compared them to propensity score matched patients never exposed to colchicine up to 1 year after the procedure. Primary outcomes included new-onset or worsening atrioventricular or left bundle-branch block (LBBB) and heart block (HB) postoperatively. Outcomes were assessed within 1 and 6 months after TAVI with an E-sensitivity analysis assessing the impact of unmeasured confounders.
RESULTS: Of 52 860 patients, 705 were on preoperative colchicine. After matching, each group included 702 patients. Colchicine was associated with a statistically significant reduction of new-onset or worsening atrioventricular/left bundle-branch block and heart block post TAVI at 1 month (relative risk [RR], 0.867 [95% CI, 0.756-0.994], P=0.041; RR, 0.887 [95% CI, 0.788-0.999], P=0.047, respectively) but not at 6 months (RR, 0.886 [95% CI, 0.779-1.077], P=0.064; RR, 0.913 [95% CI, 0.817-1.020], P=0.109, respectively). The E-value was >1.5 for the statistically significant outcomes.
CONCLUSIONS: Preoperative colchicine was associated with a lower incidence of new-onset or worsening atrioventricular/left bundle-branch block and heart block after TAVI at 1 month. However, no significant difference was observed at 6 months. Future prospective studies are needed to evaluate the definitive role of colchicine in improving TAVI outcomes.
METHODS: We used the TriNetX platform, a data repository of health record data from health care organizations in the United States, to identify patients receiving any colchicine prescription within 3 months before their first TAVI and compared them to propensity score matched patients never exposed to colchicine up to 1 year after the procedure. Primary outcomes included new-onset or worsening atrioventricular or left bundle-branch block (LBBB) and heart block (HB) postoperatively. Outcomes were assessed within 1 and 6 months after TAVI with an E-sensitivity analysis assessing the impact of unmeasured confounders.
RESULTS: Of 52 860 patients, 705 were on preoperative colchicine. After matching, each group included 702 patients. Colchicine was associated with a statistically significant reduction of new-onset or worsening atrioventricular/left bundle-branch block and heart block post TAVI at 1 month (relative risk [RR], 0.867 [95% CI, 0.756-0.994], P=0.041; RR, 0.887 [95% CI, 0.788-0.999], P=0.047, respectively) but not at 6 months (RR, 0.886 [95% CI, 0.779-1.077], P=0.064; RR, 0.913 [95% CI, 0.817-1.020], P=0.109, respectively). The E-value was >1.5 for the statistically significant outcomes.
CONCLUSIONS: Preoperative colchicine was associated with a lower incidence of new-onset or worsening atrioventricular/left bundle-branch block and heart block after TAVI at 1 month. However, no significant difference was observed at 6 months. Future prospective studies are needed to evaluate the definitive role of colchicine in improving TAVI outcomes.