TY - JOUR
T1 - Preoperative Colchicine and Conduction Disturbances After Transcatheter Aortic Valve Implantation
T2 - A US Retrospective Cohort Analysis
AU - Abdelsayed, Kerollos
AU - Amer, Basma Ehab
AU - Mohamed, Ahmed Almahdy
AU - Fouad, Michele
AU - Amin, Ahmed Mazen
AU - Ibrahim, Mahmoud Mahmoud
AU - Thangjui, Sittinun
AU - Abdelazeem, Basel
AU - Balla, Sudarshan
AU - Latib, Azeem
N1 - Publisher Copyright:
© 2025 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
PY - 2025/7/29
Y1 - 2025/7/29
N2 - BACKGROUND: Conduction disturbances are frequent complications following transcatheter aortic valve intervention (TAVI), partially driven by inflammation. The anti-inflammatory role of colchicine on these disorders post TAVI has not been studied yet. Therefore, we investigated the association between preoperative colchicine use and conduction disturbances after TAVI. METHODS: We used the TriNetX platform, a data repository of health record data from health care organizations in the United States, to identify patients receiving any colchicine prescription within 3months before their first TAVI and compared them to propensity score matched patients never exposed to colchicine up to 1year after the procedure. Primary outcomes included new-onset or worsening atrioventricular or left bundle-branch block (LBBB) and heart block (HB) postoperatively. Outcomes were assessed within 1 and 6months after TAVI with an E-sensitivity analysis assessing the impact of unmeasured confounders. RESULTS: Of 52860 patients, 705 were on preoperative colchicine. After matching, each group included 702 patients. Colchicine was associated with a statistically significant reduction of new-onset or worsening atrioventricular/left bundle-branch block and heart block post TAVI at 1month (relative risk [RR], 0.867 [95% CI, 0.756–0.994], P=0.041; RR, 0.887 [95% CI, 0.788–0.999], P=0.047, respectively) but not at 6months (RR, 0.886 [95% CI, 0.779–1.077], P=0.064; RR, 0.913 [95% CI, 0.817–1.020], P=0.109, respectively). The E-value was >1.5 for the statistically significant outcomes. CONCLUSIONS: Preoperative colchicine was associated with a lower incidence of new-onset or worsening atrioventricular/left bundle-branch block and heart block after TAVI at 1month. However, no significant difference was observed at 6months. Future prospective studies are needed to evaluate the definitive role of colchicine in improving TAVI outcomes.
AB - BACKGROUND: Conduction disturbances are frequent complications following transcatheter aortic valve intervention (TAVI), partially driven by inflammation. The anti-inflammatory role of colchicine on these disorders post TAVI has not been studied yet. Therefore, we investigated the association between preoperative colchicine use and conduction disturbances after TAVI. METHODS: We used the TriNetX platform, a data repository of health record data from health care organizations in the United States, to identify patients receiving any colchicine prescription within 3months before their first TAVI and compared them to propensity score matched patients never exposed to colchicine up to 1year after the procedure. Primary outcomes included new-onset or worsening atrioventricular or left bundle-branch block (LBBB) and heart block (HB) postoperatively. Outcomes were assessed within 1 and 6months after TAVI with an E-sensitivity analysis assessing the impact of unmeasured confounders. RESULTS: Of 52860 patients, 705 were on preoperative colchicine. After matching, each group included 702 patients. Colchicine was associated with a statistically significant reduction of new-onset or worsening atrioventricular/left bundle-branch block and heart block post TAVI at 1month (relative risk [RR], 0.867 [95% CI, 0.756–0.994], P=0.041; RR, 0.887 [95% CI, 0.788–0.999], P=0.047, respectively) but not at 6months (RR, 0.886 [95% CI, 0.779–1.077], P=0.064; RR, 0.913 [95% CI, 0.817–1.020], P=0.109, respectively). The E-value was >1.5 for the statistically significant outcomes. CONCLUSIONS: Preoperative colchicine was associated with a lower incidence of new-onset or worsening atrioventricular/left bundle-branch block and heart block after TAVI at 1month. However, no significant difference was observed at 6months. Future prospective studies are needed to evaluate the definitive role of colchicine in improving TAVI outcomes.
KW - TAVI
KW - TriNetX
KW - colchicine
KW - conduction disturbances
KW - heart block
KW - transcatheter aortic valve implantation
UR - https://www.scopus.com/pages/publications/105013029079
UR - https://www.scopus.com/pages/publications/105013029079#tab=citedBy
U2 - 10.1161/JAHA.125.043791
DO - 10.1161/JAHA.125.043791
M3 - Article
C2 - 40728176
AN - SCOPUS:105013029079
SN - 2047-9980
VL - 14
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 15
M1 - e043791
ER -