Rationale and design of the COlchicine for Prevention of the Post-pericardiotomy Syndrome and Post-operative Atrial Fibrillation (COPPS-2 trial): a randomized, placebo-controlled, multicenter study on the use of colchicine for the primary prevention of the postpericardiotomy syndrome, postoperative effusions, and postoperative atrial fibrillation.

Abstract

BACKGROUND:

The efficacy and safety of colchicine for the primary prevention of the postpericardiotomy syndrome (PPS), postoperative effusions, and postoperative atrial fibrillation (POAF) remain uncertain. Although preliminary data from a single trial of colchicine given for 1 month postoperatively (COPPS trial) were promising, the results have not been confirmed in a large, multicenter trial. Moreover, in the COPPS trial, colchicine was given 3 days postoperatively.

METHODS:

The COPPS-2 study is a multicenter, double-blind, placebo-controlled randomized trial. Forty-eight to 72 hours before planned cardiac surgery, 360 patients, 180 in each treatment arm, will be randomized to receive placebo or colchicine without a loading dose (0.5 mg twice a day for 1 month in patients weighing ≥70 kg and 0.5 mg once for patients weighing <70 kg or intolerant to the highest dose). The primary efficacy end point is the incidence of PPS, postoperative effusions, and POAF at 3 months after surgery. Secondary end points are the incidence of cardiac tamponade or need for pericardiocentesis or thoracentesis, PPS recurrence, disease-related admissions, stroke, and overall mortality.

CONCLUSIONS:

The COPPS-2 trial will evaluate the use of colchicine for the primary prevention of PPS, postoperative effusions, and POAF, potentially providing stronger evidence to support the use of preoperative colchicine without a loading dose to prevent several postoperative complications. ClinicalTrials.gov Identifier: NCT01552187.

• Authors: Massimo Imazio, Riccardo Belli, Antonio Brucato, Paolo Ferrazzi, Davide Patrini, Luigi Martinelli, Vincenzo Polizzi, Roberto Cemin, Anna Leggieri, Alida L P Caforio, Yaron Finkelstein, Brian Hoit, Bernhard Maisch, Bongani M Mayosi, Jae K Oh, Arsen D Ristic, Petar Seferovic, David H Spodick, Yehuda Adler
• Journal: American heart journal (Am Heart J) Vol. 166 Issue 1 Pg. 13-9 (Jul 2013) ISSN: 1097-6744 [Electronic] United States
• PMID: 23816016 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2013 Mosby, Inc. All rights reserved.

Chemical References

• Tubulin Modulators
• Colchicine

Topics

• Atrial Fibrillation (etiology, prevention & control)
• Colchicine (therapeutic use)
• Humans
• Multicenter Studies as Topic (methods)
• Pericardial Effusion (etiology, prevention & control)
• Pericardiectomy (adverse effects)
• Postoperative Complications (etiology, prevention & control)
• Primary Prevention (methods)
• Randomized Controlled Trials as Topic (methods)
• Syndrome
• Tubulin Modulators (therapeutic use)