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Name
Dilakshan Srikanthan

Tue, 11/16/2021 - 17:22

Dear Kyla,
Thank you so much for facilitating our discussion and for this wonderful summary of our Grand Rounds and subsequent discussion. One of the most interesting topics from Dr. Conen’s talk was the investigation of anti-inflammatory agents for treatment of AF. Particularly, Dr. Conen discussed the use of Colchicine for the prevention of perioperative atrial fibrillation in patients undergoing thoracic surgery. However, two recent papers on colchicine for postoperative atrial fibrillation showed conflicting results. The first showed that postoperatively-initiated adjusted dose colchicine prevented postoperative atrial fibrillation and shortened hospital stay without significant adverse effects in a double-blind randomized trial (1) while the second showed preoperatively-initiated fixed-dose colchicine failed to show reduced postoperative atrial fibrillation risk and colchicine treatment was associated with significant gastrointestinal side effects (2). Indeed further investigation is required and the different time of colchicine administration may be an important reason for the conflicting results. However, how do you think this would inform Dr. Conen’s trial and how do you think Dr. Conen’s trial can further add to the literature? Would love to hear your thoughts!

Best,
Dilakshan Srikanthan

1) Imazio M, Brucato A, Ferrazzi P, Rovere ME, Gandino A, Cemin R, et al. COPPS Investigators. Colchicine reduces postoperative atrial fibrillation: Results of the Colchicine for the Prevention of the Postpericardiotomy Syndrome (COPPS) atrial fibrillation substudy. Circulation. 2011;124:2290–2295.
2) Imazio M, Brucato A, Ferrazzi P, Pullara A, Adler Y, Barosi A, et al. COPPS-2 Investigators. Colchicine for prevention of postpericardiotomy syndrome and postoperative atrial fibrillation: The COPPS-2 randomized clinical trial. JAMA. 2014;312:1016–1023.

Name
Dilakshan Srikanthan

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