Muhammad Furqan Saleem, Tuba Ashraf, Ahmed Mekki, Usama Siddique, Muhammad Usama Javed, Chaudhry Bilal Rauf, Chaudhary Hammad Jamil, Azaz Ali Shah, Muhammad Usman Haider, Salman Ahsan, Mohammad Ebad Ur Rehman, Huzaifa Ahmad Cheema, Bilawal Nadeem, Raheel Ahmed
Colchicine is an anti-inflammatory drug that has emerged as a potential treatment option following myocardial infarction (MI). This meta-analysis assesses the efficacy and safety of colchicine in patients following an MI. A comprehensive literature search was performed using the Cochrane Library, ClinicalTrials.gov, Embase, and MEDLINE, covering studies from their inception to December 2025. RevMan was used to perform a random-effects meta-analysis, and forest plots were used to visualize pooled estimates. The Mantel-Haenszel method was applied to analyze dichotomous outcomes. Nine randomized control trials (RCTs) were included in this meta-analysis, including 13,834 patients. The analysis revealed that there was no statistically significant difference between colchicine and placebo groups in all-cause mortality [relative risk (RR)=0.93, confidence interval (CI)=0.78-1.11], cardiac death (RR=0.95, CI=0.73-1.22), MI (RR=0.82, CI=0.67-1.00), stroke (RR=0.64, CI=0.26-1.58), adverse events (RR=1.01, CI=0.85-1.21), serious adverse events (RR=0.96, CI=0.87-1.05), serious gastrointestinal adverse events (RR=1.35, CI=0.94-1.95), and serious infections (RR=1.00, CI=0.62-1.62). However, there was an increased risk of diarrhea in people with colchicine compared to the placebo (RR=2.12, CI=1.35-3.32). This meta-analysis demonstrates that colchicine following an MI does not have a significant impact on cardiovascular events or major adverse events other than an increased risk of diarrhea. There is a need for more comprehensive RCTs with longer follow-up times to fully comprehend the potential cardiovascular benefits of colchicine.