Efficacy and safety of colchicine in patients with myocardial infarction: a systematic review and meta-analysis.

Abstract

Colchicine is an anti-inflammatory drug that has emerged as a potential treatment option following myocardial infarction (MI). This meta-analysis assesses the efficacy and safety of colchicine in patients following an MI. A comprehensive literature search was performed using the Cochrane Library, ClinicalTrials.gov, Embase, and MEDLINE, covering studies from their inception to December 2025. RevMan was used to perform a random-effects meta-analysis, and forest plots were used to visualize pooled estimates. The Mantel-Haenszel method was applied to analyze dichotomous outcomes. Nine randomized control trials (RCTs) were included in this meta-analysis, including 13,834 patients. The analysis revealed that there was no statistically significant difference between colchicine and placebo groups in all-cause mortality [relative risk (RR)=0.93, confidence interval (CI)=0.78-1.11], cardiac death (RR=0.95, CI=0.73-1.22), MI (RR=0.82, CI=0.67-1.00), stroke (RR=0.64, CI=0.26-1.58), adverse events (RR=1.01, CI=0.85-1.21),  serious adverse events (RR=0.96, CI=0.87-1.05), serious gastrointestinal adverse events (RR=1.35, CI=0.94-1.95), and serious infections (RR=1.00, CI=0.62-1.62). However, there was an increased risk of diarrhea in people with colchicine compared to the placebo (RR=2.12, CI=1.35-3.32). This meta-analysis demonstrates that colchicine following an MI does not have a significant impact on cardiovascular events or major adverse events other than an increased risk of diarrhea. There is a need for more comprehensive RCTs with longer follow-up times to fully comprehend the potential cardiovascular benefits of colchicine.