Effect of Colchicine on the Incidence of Atrial Fibrillation in Open Heart Surgery Patients

Effect of ColchiciNe on the InciDence of Atrial Fibrillation in Open Heart Surgery Patients: END-AF Trial

This study evaluates the role of colchicine in the prevention of atrial fibrillation in patients undergoing open heart surgery. Half of participants will receive colchicine and the other half will not

Atrial fibrillation (AF) is the most common arrhythmia in patients undergoing cardiac surgery and is estimated to occur in 26% of all cardiac surgery patients. It can lead to increase morbidity, mainly due to hemodynamic instability and thromboembolic complications, and to increased hospital stay with its associated higher health care cost.

Previous studies have demonstrated that increased inflammation may precede AF and, therefore, interventions that reduce the inflammatory process may help reduce the incidence of AF. Colchicine has potent anti-inflammatory properties and may therefore be capable of reducing the incidence of AF.

This study aims to determine whether the administration of colchicine starting the day before cardiac surgery and continuing until discharge may lead to reduction in post-operative AF.

Inclusion Criteria:

• All consecutive adult patients undergoing elective cardiac surgery

Exclusion Criteria:

• Documented history of AF or supraventricular arrhythmia or, absence of sinus rhythm on hospital admission
• Known severe liver disease or current transaminases >1.5 times the upper normal limit
• Current serum creatinine >2.5 mg/dl
• Known myopathy or elevated baseline preoperative creatine kinase
• Known blood dyscrasias
• Significant gastrointestinal disease
• Pregnant and lactating women
• Known hypersensitivity to colchicine
• Current treatment with colchicine for any indications
• Emergency surgery