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2025, Vol: 50, Issue: 4
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Review Article 


Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis

Darmadi Darmadi, Herwindo Ahmad, Cennikon Pakpahan, Sem Samuel Surja.


Abstract
Objectives: To evaluate the efficacy and safety of colchicine in preventing adverse cardiovascular outcomes in adults with coronary artery disease (CAD).
Methodology: This systematic review and meta-analysis were conducted by searching PubMed, Scopus, and the Cochrane Library databases. Randomized controlled trials (RCTs) assessing the effects of colchicine on cardiac mortality, cardiac injury, or adverse events in adults aged 18 years and older with CAD were included. Data extraction and risk of bias assessment were independently performed by two reviewers. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for dichotomous outcomes, and mean differences (MD) for continuous outcomes. A random-effects model was applied to synthesize data.
Results: Seven RCTs met the inclusion criteria and were analyzed. Colchicine treatment was associated with a statistically significant reduction in cardiovascular mortality (OR = 0.75; 95% CI, 0.60–0.92; p=0.007). However, the effects on cardiac injury markers were not statistically significant and demonstrated high heterogeneity. Safety outcomes also showed no significant difference overall but revealed variability across studies. Some trials reported increased incidences of gastrointestinal adverse effects, as well as elevations in liver enzymes (alanine aminotransferase) and muscle injury markers (creatine kinase), indicating potential hepatic and muscular side effects.
Conclusion: Colchicine shows potential in significantly reducing cardiovascular mortality in adults with CAD. Nevertheless, its impact on cardiac injury and safety profiles remains inconclusive, highlighting the need for further standardized, high-quality trials to inform clinical practice.

Key words: Coronary artery disease, colchicine, cardiovascular mortality, systematic review, meta-analysis.


 
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How to Cite this Article
Pubmed Style

Darmadi D, Ahmad H, Pakpahan C, Surja SS. Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis. RMJ. 2025; 50(3): 819-804. doi:10.5455/rmj.20250409042809

Web Style

Darmadi D, Ahmad H, Pakpahan C, Surja SS. Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis. https://www.rmj.org.pk/?mno=251845 [Access: October 30, 2025]. doi:10.5455/rmj.20250409042809

AMA (American Medical Association) Style

Darmadi D, Ahmad H, Pakpahan C, Surja SS. Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis. RMJ. 2025; 50(3): 819-804. doi:10.5455/rmj.20250409042809


Vancouver/ICMJE Style

Darmadi D, Ahmad H, Pakpahan C, Surja SS. Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis. RMJ. (2025), [cited October 30, 2025]; 50(3): 819-804. doi:10.5455/rmj.20250409042809


Harvard Style

Darmadi, D., Ahmad, . H., Pakpahan, . C. & Surja, . S. S. (2025) Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis. RMJ, 50 (3), 819-804. doi:10.5455/rmj.20250409042809


Turabian Style

Darmadi, Darmadi, Herwindo Ahmad, Cennikon Pakpahan, and Sem Samuel Surja. 2025. Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis. Rawal Medical Journal, 50 (3), 819-804. doi:10.5455/rmj.20250409042809


Chicago Style

Darmadi, Darmadi, Herwindo Ahmad, Cennikon Pakpahan, and Sem Samuel Surja. "Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis." Rawal Medical Journal 50 (2025), 819-804. doi:10.5455/rmj.20250409042809


MLA (The Modern Language Association) Style

Darmadi, Darmadi, Herwindo Ahmad, Cennikon Pakpahan, and Sem Samuel Surja. "Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis." Rawal Medical Journal 50.3 (2025), 819-804. Print. doi:10.5455/rmj.20250409042809


APA (American Psychological Association) Style

Darmadi, D., Ahmad, . H., Pakpahan, . C. & Surja, . S. S. (2025) Efficacy and safety of colchicine in reducing cardiovascular mortality and cardiac injury among adult patients with coronary artery disease: A systematic review and meta-analysis. Rawal Medical Journal, 50 (3), 819-804. doi:10.5455/rmj.20250409042809


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