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Effects of oral colchicine administration as first-line adjunct therapy in myopericarditis

Auswirkungen der Gabe von Colchicin oral als Erstlinientherapieergänzung bei Myoperikarditis

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Abstract

Background

Although current guidelines recommend routine use of oral colchicine as a first-line adjunct therapy to aspirin/nonsteroidal anti-inflammatory drugs (NSAIDs) for acute and recurrent pericarditis, there are insufficient data to recommend routine use of colchicine for the initial management of myopericarditis.

Methods

The records of 194 patients who were admitted for myopericarditis were investigated retrospectively. Patients receiving oral colchicine (n = 33) as an adjunct to aspirin/NSAIDs comprised the study group and patients who received conventional therapy (n = 31) formed the control group. Plasma C‑reactive protein (CRP) levels, cardiac biomarkers, and several electrocardiographic parameters of atrial activation were evaluated before the start of treatment and at the 6‑month follow-up.

Results

Assessments before and after treatment with regard to cardiac biomarkers and plasma CRP levels showed improvements in both groups (p > 0.05). There were statistically significant improvements in P wave indices including P wave duration, PR interval length, P wave dispersion, P terminal force, and isoelectric interval in the colchicine therapy group compared with the control group (p < 0.01).

Conclusion

Routine use of colchicine for the initial management of myopericarditis as a first-line adjunct therapy to aspirin/NSAIDs in patients with myopericarditis has favorable effects on electrocardiographic indices of atrial activation parameters.

Zusammenfassung

Hintergrund

Zwar wird in aktuellen Leitlinien die Standardanwendung von Colchicin oral als Ergänzung zur Erstlinientherapie mit Acetylsalicylsäure/nichsteroidalen Antirheumatika (NSAR) bei akuter und rezidivierende Perikarditis empfohlen, aber es stehen nur unzureichend Daten zur Verfügung, um den Routineeinsatz von Colchicin für die initiale Behandlung der Myoperikarditis zu empfehlen.

Methoden

Die Krankenunterlagen von 194 Patienten, die wegen Myoperikarditis stationär aufgenommen worden waren, wurden retrospektiv untersucht. Patienten, die Colchicin oral als Ergänzung zu Acetylsalicylsäure/NSAR erhielten (n = 33), bildeten die Studiengruppe, und Patienten, die konventionell therapiert wurden (n = 31), bildeten die Kontrollgruppe. C‑reaktives Protein (CRP) im Plasma, kardiale Biomarker und verschiedene elektrokardiographische Parameter der Vorhofaktivierung wurden vor Beginn der Behandlung und bei der Nachuntersuchung nach 6 Monaten untersucht.

Ergebnisse

Die Untersuchungen in Bezug auf kardiale Biomarker und CRP im Plasma vor und nach Behandlung ergaben Verbesserungen in beiden Gruppen (p > 0,05). Statistisch signifikante Verbesserungen zeigten sich in der Gruppe mit Colchicintherapie im Vergleich zur Kontrollgruppe (p < 0,01) bei den P‑Wellen-Indizes einschließlich der P‑Wellen-Länge, der Länge des PR-Intervalls, der P‑Wellen-Dispersion, des negativen Anteils der P‑Welle in V1 und des isoelektrischen Intervalls.

Schlussfolgerung

Die Routineanwendung von Colchicin für die initiale Behandlung der Myoperikarditis als Ergänzung der Erstlinientherapie mit Acetylsalicylsäure/NSAR bei Patienten mit Myoperikarditis hat günstige Auswirkungen auf elektrokardiographische Indizes von Parametern der Vorhofaktivierung.

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Authors and Affiliations

  1. Department of Cardiology, Konya Training and Research Hospital, Konya, Turkey

    Mustafa Duran MD & Murat Ziyrek MD

  2. Meram Medical Faculty Department of Cardiology Meram/Konya, Necmettin Erbakan University, 042065, Meram/Konya, Turkey

    Yakup Alsancak MD

Authors
  1. Mustafa Duran MD
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  2. Yakup Alsancak MD
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  3. Murat Ziyrek MD
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Contributions

Concept – M.D., M.Z.; Design – M.D., M.Z., Y.A. Supervision – Y.A., M.Z.; Resource – M.D., M.Z.; Materials – M.D., M.Z.; Data Collection and/or Processing – M.D., M.Z.; Analysis and/or Interpretation – M.Z., Y.A.; Literature Search – M.D.,Y.A.; Writing – M.D., Y.A.; Critical Reviews – Y.A.

Corresponding author

Correspondence to Yakup Alsancak MD.

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Conflict of interest

M. Duran, Y. Alsancak and M. Ziyrek declare that they have no competing interests.

The study was approved by the local ethics committee (University of Health Sciences, Konya Educational and Research Hospital, Konya, Turkey; 13.09.2019/93/2048 ID number). The investigation conforms to the principles outlined in the Declaration of Helsinki.

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Duran, M., Alsancak, Y. & Ziyrek, M. Effects of oral colchicine administration as first-line adjunct therapy in myopericarditis. Herz 47, 166–174 (2022). https://doi.org/10.1007/s00059-021-05040-3

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  • DOI: https://doi.org/10.1007/s00059-021-05040-3

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