2026 Eastern States Conference

Authors: Ngan Le, PharmD; Lauren Albertina, PharmD, BCCCP; Kimberly Hall, PharmD, BCCP, BCPS 

Learning Objective: Audience members will be able to explain the role of colchicine in the prevention of post-operative atrial fibrillation (POAF) following cardiothoracic surgery. 

Background/Objective: The purpose of this study is to evaluate the safety and effectiveness of the addition of colchicine to institutional standard of amiodarone and beta blocker therapy for the prevention of POAF in patients who have undergone cardiothoracic surgery. 

Methods: This single-center retrospective cohort study was conducted at Inova Fairfax Medical Campus. Adults (≥18 years) undergoing cardiothoracic surgery requiring cardiopulmonary bypass were included. Exclusion criteria were renal dysfunction, acute kidney injury, transaminitis, chronic liver disease, congenital heart disease, or colchicine use for other indications. The colchicine group consisted of patients from January-June 2025 who received colchicine 0.6 mg twice daily starting on postoperative day two. The control group consisted of patients from January-June 2024 who did not receive colchicine post-operatively. The primary outcome was the incidence of POAF. Secondary outcomes included the incidence of post-operative pericarditis, postpericardiotomy syndrome, and post-operative ileus. Safety outcomes included any events warranting colchicine dose reduction or discontinuation. Categorical variables were analyzed via two-sided Fisher’s exact or Pearson Chi-square tests where appropriate. 

Results: Over the pre-specified periods, 160 patients were included (colchicine n= 81, control n= 79). As part of the institutional POAF prophylaxis protocol, 84.4% of patients received amiodarone and 88.1% received beta blockers. POAF occurred in 19 patients (23.5%) in the colchicine group and in 23 patients (29.11%) in the control group (p=0.42). The median onset of POAF was three days after surgery. Secondary outcomes showed no difference in the incidence of post-operative pericarditis, postpericardiotomy syndrome, and post-operative ileus. Colchicine dose reduction occurred in 4.9% of patients, and discontinuation occurred in 21.0% of patients, most commonly due to diarrhea. 

Conclusions: Among patients undergoing cardiothoracic surgery, the addition of colchicine to institutional standard amiodarone and beta blocker therapy did not significantly reduce the incidence of POAF. Diarrhea was the most common adverse event leading to colchicine dose reduction or discontinuation. The study limitations included retrospective study design and limited sample size.  

Self-Assessment Question: According to our study, colchicine showed reduced incidence of post-operative atrial fibrillation in patients undergoing cardiothoracic surgery (True/False)