Colchicine For The Prevention Of Perioperative Atrial Fibrillation In Patients Undergoing Thoracic Surgery (COP-AF)

Perioperative atrial fibrillation (AF) and myocardial injury after noncardiac surgery

(MINS) are among the most common serious complications occurring after thoracic surgery.

AF is the most common perioperative cardiac arrhythmia. The incidence of perioperative AF

in patients undergoing major thoracic surgery ranges from 10% in low-risk patients to as

high as 20% in high-risk patients. The course of patients with perioperative AF is

frequently complicated by hemodynamic instability, problems with managing anticoagulation

in the early postoperative period, prolonged intensive care unit and hospital stays, and

increased costs. Patients who develop perioperative AF (POAF) or MINS also have a

significantly increased risk of death and stroke.

Colchicine is an inexpensive drug and a highly effective anti-inflammatory agent that

holds great potential for preventing POAF and MINS in patients undergoing thoracic

surgery. Data from cardiac surgery patients suggest that prevention of POAF using

colchicine is feasible, but whether this concept is also applicable to patients

undergoing thoracic surgery, where the risk of POAF is lower and underlying mechanisms

may be different, is currently unclear. The 'Colchicine for the prevention of

perioperative AF' (COP-AF) trial has been designed as a large randomized, double blind,

placebo controlled trial to determine whether colchicine, a potent, safe and inexpensive

anti-inflammatory drug, lowers the risk of perioperative AF, MINS, and other inflammatory

complications in patients undergoing thoracic surgery. The primary objective of this

trial is to determine whether a 10-day course of colchicine 0.5mg twice daily reduces the

incidence of perioperative AF and MINS within 14 days after thoracic surgery.