Колхицин в практике кардиолога: применение при фибрилляции предсердий, воспалительных заболеваниях, сердечной недостаточности и кардиологических осложнениях COVID-19

Воспаление является неотъемлемой частью патофизиологических процессов, приводящих к повреждению или регенерации сердца и сосудов. Интерес к «воспалительной теории» сердечно-сосудистых заболеваний вновь находится на пике научных исследований, что связано с открытием новых возможностей лабораторных и инструментальных методов, а также появлением новых кардиотропных вирусов, к которым относится SARS-CoV-2. Наиболее эффективным и безопасным препаратом, используемым с целью модуляции избыточного воспаления при заболеваниях сердца, является колхицин, включенный в рекомендации по терапии перимиокардита и ишемической болезни сердца с высоким классом доказательности. Кроме того, показано, что колхицин, уменьшая врожденную и отчасти приобретенную иммунную реакцию, может воздействовать на субстрат и триггер аритмии, воспалительный компонент хронического перерождения миокарда при формировании сердечной недостаточности, а также оказывать специфическое и неспецифическое позитивное влияние при кардиологических осложнениях COVID-19. Применение лекарственного средства в широкой практике кардиолога ограничено недостаточной информированностью о показаниях и побочных эффектах препарата, а в практике ревматолога – недостатком знаний о дополнительных свойствах колхицина при кардиологических заболеваниях. В обзоре собраны медицинские исследования, доступные онлайн, посвященные оценке клинической эффективности препаратов колхицина при заболеваниях, которые пока не входят в официальные рекомендации для его приема, такие, как фибрилляция предсердий, аутовоспалительные заболевания, сердечная недостаточность и кардиологические осложнения COVID-19. При каждой из перечисленных нозологий применение колхицина имеет место с учетом специфических показаний. В статью включены опубликованные в сети интернет медицинские исследования, тезисы и метаанализы без ограничений по давности публикации по июль 2025 г. Использовались базы данных PubMed, ScienceDirect, Google Scholar и CENTRAL, в которых просмотрено 520 источников литературы, описывающих клиническую эффективность препаратов колхицина, гетерогенность его эффектов в разных схемах применения при различных сердечно-сосудистых заболеваниях.

1. Сукмарова З.Н., Симоненко В.Б. Колхицин в практике кардиолога. Часть 1. Механизмы влияния на сердечно-сосудистую систему, применение в терапии перикардита и при ишемической болезни сердца. Кардиология. 2025;65(11):108-19. DOI: 10.18087/cardio.2025.11.n3016

2. Varghese B, Feldman DI, Chew C, Valilis E, Blumenthal RS, Sharma G et al. Inflammation, atrial fibrillation, and the potential role for colchicine therapy. Heart Rhythm O2. 2021;2(3):298–303. DOI: 10.1016/j.hroo.2021.03.011

3. Сукмарова З.Н., Саидова М.А., Овчинников Ю.В. Экссудативный перикардит в патогенезе нарушений ритма сердца при covid-19: серия клинических случаев. Кардиоваскулярная терапия и профилактика. 2022;21(2):72-9. DOI: 10.15829/1728-8800-2022-3021

4. Gao Z, Shi H, Xu W, Guan Z, Su X, Guo N et al. Hyperuricemia Increases the Risk of Atrial Fibrillation: A Systematic Review and Meta-Analysis. International Journal of Endocrinology. 2022;2022:1–10. DOI: 10.1155/2022/8172639

5. Kommu S, Arepally S. The Effect of Colchicine on Atrial Fibrillation: A Systematic Review and Meta-Analysis. Cureus. 2023;15(2):e35120. DOI: 10.7759/cureus.35120

6. Imazio M, Brucato A, Ferrazzi P, Rovere ME, Gandino A, Cemin R et al. Colchicine Reduces Postoperative Atrial Fibrillation: Results of the Colchicine for the Prevention of the Postpericardiotomy Syndrome (COPPS) Atrial Fibrillation Substudy. Circulation. 2011;124(21):2290–5. DOI: 10.1161/CIRCULATIONAHA.111.026153

7. Imazio M, Brucato A, Ferrazzi P, Pullara A, Adler Y, Barosi A et al. Colchicine for Prevention of Postpericardiotomy Syndrome and Postoperative Atrial Fibrillation: The COPPS-2 Randomized Clinical Trial. JAMA. 2014;312(10):1016–23. DOI: 10.1001/jama.2014.11026

8. Sarzaeem M, Shayan N, Bagheri J, Jebelli M, Mandegar M. Low dose colchicine in prevention of atrial fibrillation after coronary artery bypass graft: A double blind clinical trial. Tehran University Medical Journal. 2014;72(3):147–54

9. Zarpelon CS, Netto MC, Jorge JCM, Fabris CC, Desengrini D, Jardim MDS et al. Colchicine to Reduce Atrial Fibrillation in the Postoperative Period of Myocardial Revascularization. Arquivos Brasileiros de Cardiologia. 2016;107(1):4–9. DOI: 10.5935/abc.20160082

10. Tabbalat RA, Hamad NM, Alhaddad IA, Hammoudeh A, Akasheh BF, Khader Y. Effect of ColchiciNe on the InciDence of Atrial Fibrillation in Open Heart Surgery Patients: END-AF Trial. American Heart Journal. 2016;178:102–7. DOI: 10.1016/j.ahj.2016.05.006

11. Tabbalat RA, Alhaddad I, Hammoudeh A, Khader YS, Khalaf HA, Obaidat M et al. Effect of Low-dose ColchiciNe on the InciDence of Atrial Fibrillation in Open Heart Surgery Patients: ENDAF Low Dose Trial. Journal of International Medical Research. 2020;48(7):0300060520939832. DOI: 10.1177/0300060520939832

12. Mashayekhi NR, Alisaeedi A, Rostami A, Soltani P. The impact of colchicine in preventing postpericardiotomy syndrome; a double-blind clinical trial study. Immunopathologia Persa. 2020;6(1):e11. DOI: 10.15171/ipp.2020.11

13. Shvartz V, Le T, Enginoev S, Sokolskaya M, Ispiryan A, Shvartz E et al. Colchicine in Cardiac Surgery: The COCS Randomized Clinical Trial. Journal of Cardiovascular Development and Disease. 2022;9(10):363. DOI: 10.3390/jcdd9100363

14. Conen D, Ke Wang M, Popova E, Chan MTV, Landoni G, Cata JP et al. Effect of colchicine on perioperative atrial fibrillation and myocardial injury after non-cardiac surgery in patients undergoing major thoracic surgery (COP-AF): an international randomised trial. The Lancet. 2023;402(10413):1627–35. DOI: 10.1016/S01406736(23)01689-6

15. Deftereos S, Giannopoulos G, Kossyvakis C, Efremidis M, Panagopoulou V, Kaoukis A et al. Colchicine for Prevention of Early Atrial Fibrillation Recurrence After Pulmonary Vein Isolation: A randomized controlled study. Journal of the American College of Cardiology. 2012;60(18):1790–6. DOI: 10.1016/j.jacc.2012.07.031

16. Deftereos S, Giannopoulos G, Efremidis M, Kossyvakis C, Katsivas A, Panagopoulou V et al. Colchicine for prevention of atrial fibrillation recurrence after pulmonary vein isolation: Mid-term efficacy and effect on quality of life. Heart Rhythm. 2014;11(4):620–8. DOI: 10.1016/j.hrthm.2014.02.002

17. Egami Y, Nishino M, Shutta R, Makino N, Tanouchi J. Abstract 12012: Relation Between Colchicine and Epicardial Adipose Tissue Volume Surrounding Left Atrium in Atrial Fibrillation Recurrence After Ablation. Circulation. 2015;132(Suppl 3):A12012. DOI: 10.1161/circ.132.suppl_3.12012

18. Iqbal AM, Li KY, Gautam S. Colchicine usage for prevention of post atrial fibrillation ablation pericarditis in patients undergoing high-power short‐duration ablation. Journal of Cardiovascular Electrophysiology. 2023;34(6):1370–6. DOI: 10.1111/jce.15941

19. Benz AP, Amit G, Connolly SJ, Singh J, Acosta-Vélez JG, Conen D et al. Colchicine to Prevent Atrial Fibrillation Recurrence After Catheter Ablation: A Randomized, Placebo-Controlled Trial. Circulation: Arrhythmia and Electrophysiology. 2024;17(1):e01238. DOI: 10.1161/CIRCEP.123.012387

20. Al-Sadawi M, Aslam F, Henriques MD, Alsaiqali M, Gier C, Kim P et al. Effect of low dose colchicine on long term recurrence after atrial fibrillation ablation. International Journal of Cardiology. 2025;423:132972. DOI: 10.1016/j.ijcard.2025.132972

21. Romero JE, Matos CD, Garcia F, Enriquez A, Saenz LC, Hoyos C et al. Intrapericardial Corticosteroids and Colchicine Prevent Pericarditis and Atrial Fibrillation After Epicardial Ablation of Ventricular Arrhythmias. JACC: Clinical Electrophysiology. 2025;11(3):498–508. DOI: 10.1016/j.jacep.2024.10.033

22. Agarwal S, Beard CW, Khosla J, Clifton S, Anwaar MF, Ghani A et al. Safety and efficacy of colchicine for the prevention of post-operative atrial fibrillation in patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials. Europace. 2023;25(7):euad169. DOI: 10.1093/europace/euad169

23. Divinagracia R, Sadian AD, Cabalquinto MC. Use of Colchicine in the Prevention of Perioperative Atrial Fibrillation after Non-cardiac Thoracic Surgery. Europace. 2025;27(Suppl 1):euaf085.086. DOI: 10.1093/europace/euaf085.086

24. Rivera FB, Whoy Cha S, Aparece JP, Jariyatamkitti S, Mamas MA. Efficacy and Safety of Colchicine for the Prevention of Postoperative Atrial Fibrillation Among Patients Undergoing Major Cardiothoracic Surgery: A Meta-analysis and Meta-regression of Randomized Controlled Trials. Journal of Cardiovascular Pharmacology. 2024;83(3):265–70. DOI: 10.1097/FJC.0000000000001533

25. Wang X, Peng X, Li Y, Lin R, Liu X, Ruan Y et al. Colchicine for Prevention of Post-Cardiac Surgery and Post-Pulmonary Vein Isolation Atrial Fibrillation: A Meta-Analysis. Reviews in Cardiovascular Medicine. 2022;23(12):387. DOI: 10.31083/j.rcm2312387

26. Bulhões E, Florêncio De Mesquita C, Madeira De Sá Pacheco I, Karlinski Vizentin V. Effects of colchicine on the prevention of AF recurrence after atrial ablation: a systematic review and meta-analysis. Journal of Interventional Cardiac Electrophysiology. 2024;67(8):1951–8. DOI: 10.1007/s10840-024-01770-6

27. Borra V, Mahadevan A, Gautam Senapati S, Vempati R, Jaiswal V, Borra N et al. The efficacy of colchicine in preventing atrial fibrillation recurrence and pericarditis post-catheter ablation for atrial fibrillation – A systematic review and meta-analysis of prospective studies. IJC Heart & Vasculature. 2024;53:101466. DOI: 10.1016/j.ijcha.2024.101466

28. Mir J, Haider MZ, Hamza M, Ishaq S, Al-Ahmad M, Khalid Y et al. E-117. Impact of Colchicine on Atrial Fibrillation Recurrence Following Catheter Ablation: Meta-Analysis. Journal of the Society for Cardiovascular Angiography & Interventions. 2025;4(5):59–60. DOI: 10.1016/j.jscai.2025.103378

29. Soliman Y, Mouffokes A, Hukamdad M, Allababidi M, Hassaballa H. Colchicine for atrial fibrillation prevention after catheter ablation: a systematic review and meta-analysis. JACC. 2025;85(12 Suppl):60. DOI: 10.1016/S0735-1097(25)00545-5

30. Mishra S, Kass DA. Cellular and molecular pathobiology of heart failure with preserved ejection fraction. Nature Reviews Cardiology. 2021;18(6):400–23. DOI: 10.1038/s41569-020-00480-6

31. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2021;42(36):3599–726. DOI: 10.1093/eurheartj/ehab368

32. Murphy SP, Kakkar R, McCarthy CP, Januzzi JL. Inflammation in Heart Failure: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2020;75(11):1324–40. DOI: 10.1016/j. jacc.2020.01.014

33. Rauchhaus M, Doehner W, Francis DP, Davos C, Kemp M, Liebenthal C et al. Plasma Cytokine Parameters and Mortality in Patients With Chronic Heart Failure. Circulation. 2000;102(25):3060–7. DOI: 10.1161/01.CIR.102.25.3060

34. Pappritz K, Lin J, El‐Shafeey M, Fechner H, Kühl U, Alogna A et al. Colchicine prevents disease progression in viral myocarditis via modulating the NLRP3 inflammasome in the cardiosplenic axis. ESC Heart Failure. 2022;9(2):925–41. DOI: 10.1002/ehf2.13845

35. Caforio ALP, Giordani AS, Baritussio A, Marcolongo D, Vicenzetto C, Tarantini G et al. Long‐term efficacy and safety of tailored immunosuppressive therapy in immune‐mediated biopsy‐proven myocarditis: A propensity‐weighted study. European Journal of Heart Failure. 2024;26(5):1175–85. DOI: 10.1002/ejhf.3220

36. Sun X, Duan J, Gong C, Feng Y, Hu J, Gu R et al. Colchicine Ameliorates Dilated Cardiomyopathy Via SIRT2‐Mediated Suppression of NLRP3 Inflammasome Activation. Journal of the American Heart Association. 2022;11(13):e025266. DOI: 10.1161/JAHA.122.025266

37. Deftereos S, Giannopoulos G, Panagopoulou V, Bouras G, Raisakis K, Kossyvakis C et al. Anti-Inflammatory Treatment With Colchicine in Stable Chronic Heart Failure: a prospective, randomized study. JACC: Heart Failure. 2014;2(2):131–7. DOI: 10.1016/j.jchf.2013.11.006

38. Pascual-Figal D, Núñez J, Pérez-Martínez MT, González-Juanatey JR, Taibo-Urquia M, Llàcer-Iborra P et al. Colchicine in acutely decompensated heart failure: the COLICA trial. European Heart Journal. 2024;45(45):4826–36. DOI: 10.1093/eurheartj/ehae538

39. Pi S, Xiong S, Yuan Y, Deng H. The Role of Inflammasome in Abdominal Aortic Aneurysm and Its Potential Drugs. International Journal of Molecular Sciences. 2024;25(9):5001. DOI: 10.3390/ijms25095001

40. Chen M, Yang D, Zhou Y, Yang C, Lin W, Li J et al. Colchicine Blocks Abdominal Aortic Aneurysm Development by Maintaining Vascular Smooth Muscle Cell Homeostasis. International Journal of Biological Sciences. 2024;20(6):2092–110. DOI: 10.7150/ijbs.93544

41. Hu J, Xu J, Zhao J, Liu Y, Huang R, Yao D et al. Colchicine ameliorates short-term abdominal aortic aneurysms by inhibiting the expression of NLRP3 inflammasome components in mice. European Journal of Pharmacology. 2024;964:176297. DOI: 10.1016/j.ejphar.2023.176297

42. Shah B, Toprover M, Crittenden DB, Jeurling S, Pike VC, Krasnokutsky S et al. Colchicine Use and Incident Coronary Artery Disease in Male Patients With Gout. Canadian Journal of Cardiology. 2020;36(11):1722–8. DOI: 10.1016/j.cjca.2020.05.026

43. Crittenden DB, Lehmann RA, Schneck L, Keenan RT, Shah B, Greenberg JD et al. Colchicine Use Is Associated with Decreased Prevalence of Myocardial Infarction in Patients with Gout. The Journal of Rheumatology. 2012;39(7):1458–64. DOI: 10.3899/jrheum.111533

44. Solomon DH, Liu C-C, Kuo I-H, Zak A, Kim SC. Effects of colchicine on risk of cardiovascular events and mortality among patients with gout: a cohort study using electronic medical records linked with Medicare claims. Annals of the Rheumatic Diseases. 2016;75(9):1674–9. DOI: 10.1136/annrheumdis-2015-207984

45. Cipolletta E, Nakafero G, McCormick N, Yokose C, Avery AJ, Mamas MA et al. Cardiovascular events in patients with gout initiating urate-lowering therapy with or without colchicine for flare prophylaxis: a retrospective new-user cohort study using linked primary care, hospitalisation, and mortality data. The Lancet Rheumatology. 2025;7(3):e197–207. DOI: 10.1016/S2665-9913(24)00248-0

46. Ho GH, Toprover M, Crittenden DB, Shah B, Pillinger MH. Colchicine Use and Major Adverse Cardiovascular Events in Male Patients with Gout and Established Coronary Artery Disease: A Veterans Affairs Nested Retrospective Cohort Study. Gout, Urate, and Crystal Deposition Disease. 2023;1(1):11–24. DOI: 10.3390/gucdd1010003

47. Heijman MWJ, Fiolet ATL, Mosterd A, Tijssen JGP, Van Den Bemt BJF, Schut A et al. Association of Low-Dose Colchicine With Incidence of Knee and Hip Replacements: Exploratory Analyses From a Randomized, Controlled, Double-Blind Trial. Annals of Internal Medicine. 2023;176(6):737–42. DOI: 10.7326/M23-0289

48. Langevitz P, Livneh A, Neumann L, Buskila D, Shemer J, Amolsky D et al. Prevalence of ischemic heart disease in patients with familial Mediterranean fever. Israel Medical Association Journal. 2001;3(1):9–12. PMID: 11344818

49. Karpouzas GA, Ormseth SR, Van Riel PLCM, Gonzalez-Gay MA, Corrales A, Rantapää-Dahlqvist S et al. Biological use influences the impact of inflammation on risk of major adverse cardiovascular events in rheumatoid arthritis. RMD Open. 2024;10(3):e004546. DOI: 10.1136/rmdopen-2024-004546

50. Li Z, Lin C, Cai X, Hu S, Lv F, Yang W et al. Anti-inflammatory therapies were associated with reduced risk of myocardial infarction in patients with established cardiovascular disease or high cardiovascular risks: A systematic review and meta-analysis of randomized controlled trials. Atherosclerosis. 2023;379:117181. DOI: 10.1016/j.atherosclerosis.2023.06.972

51. Vrachatis DA, Giannopoulos GV, Giotaki SG, Raisakis K, Kossyvakis C, Iliodromitis KE et al. Impact of colchicine on mortality in patients with COVID-19: A meta-analysis. Hellenic Journal of Cardiology. 2021;62(5):374–7. DOI: 10.1016/j.hjc.2020.11.012

52. Elshafei MN, El‐Bardissy A, Khalil A, Danjuma M, Mubasher M, Abubeker IY et al. Colchicine use might be associated with lower mortality in COVID‐19 patients: A meta‐analysis. European Journal of Clinical Investigation. 2021;51(9):e13645. DOI: 10.1111/eci.13645

53. Chiu L, Lo C-H, Shen M, Chiu N, Aggarwal R, Lee J et al. Colchicine use in patients with COVID-19: A systematic review and meta-analysis. PLOS ONE. 2021;16(12):e0261358. DOI: 10.1371/journal. pone.0261358

54. Salah HM, Mehta JL. Meta-analysis of the Effect of Colchicine on Mortality and Mechanical Ventilation in COVID-19. The American Journal of Cardiology. 2021;145:170–2. DOI: 10.1016/j.amjcard.2021.02.005

55. Nawangsih EN, Kusmala YY, Rakhmat II, Handayani DR, Juliastuti H, Wibowo A et al. Colchicine and mortality in patients with coronavirus disease 2019 (COVID-19) pneumonia: A systematic review, meta-analysis, and meta-regression. International Immunopharmacology. 2021;96:107723. DOI: 10.1016/j.intimp.2021.107723

56. Hariyanto TI, Halim DA, Jodhinata C, Yanto TA, Kurniawan A. Colchicine treatment can improve outcomes of coronavirus disease 2019 (COVID‐19): A systematic review and meta‐analysis. Clinical and Experimental Pharmacology and Physiology. 2021;48(6):823–30. DOI: 10.1111/1440-1681.13488

57. Elshiwy K, Amin GEE-D, Farres MN, Samir R, Allam MF. The role of colchicine in the management of COVID-19: a Meta-analysis. BMC Pulmonary Medicine. 2024;24(1):190. DOI: 10.1186/s12890-024-03001-0

58. Rabbani A, Rafique A, Wang X, Campbell D, Wang D, Brownell N et al. Colchicine for the Treatment of Cardiac Injury in Hospitalized Patients With Coronavirus Disease-19. Frontiers in Cardiovascular Medicine. 2022;9:876718. DOI: 10.3389/fcvm.2022.876718

59. Сукмарова З.Н., Паршин В.В., Шишиморов А.А., Громов А.И. Полисерозит как негативный прогностический фактор COVID-19. Наблюдения ГКБ №52 в начале и в конце пандемии. Медицинская визуализация. 2025;29(2):20-8. DOI: 10.24835/1607-0763-1496

60. Sukmarova Z, Saidova M. Echocardiographic phenomenon of pericarditis in patients with severe COVID-19 pneumonia. One-year observation. European Heart Journal - Cardiovascular Imaging. 2022;23(Suppl 1):jeab289.278. DOI: 10.1093/ehjci/jeab289.278

61. Zuin M, Imazio M, Rigatelli G, Pasquetto G, Bilato C. Risk of incident pericarditis after coronavirus disease 2019 recovery: a systematic review and meta-analysis. Journal of Cardiovascular Medicine. 2023;24(11):822–8. DOI: 10.2459/JCM.0000000000001536

62. DeVries A, Shambhu S, Sloop S, Overhage JM. One-Year Adverse Outcomes Among US Adults With Post–COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database. JAMA Health Forum. 2023;4(3):e230010. DOI: 10.1001/jamahealthforum.2023.0010

63. Zuin M, Mazzitelli M, Rigatelli G, Bilato C, Cattelan AM. Risk of ischemic stroke in patients recovered from COVID-19 infection: A systematic review and meta-analysis. European Stroke Journal. 2023;8(4):915–22. DOI: 10.1177/23969873231190432

64. Yeh J-J, Hung T-W, Lin C-L, Chen T-T, Liw P-X, Yu Y-L et al. Colchicine Is a Weapon for Managing the Heart Disease Among Interstitial Lung Disease With Viral Infection: Have We Found the Holy Grail? Frontiers in Cardiovascular Medicine. 2022;9:925211. DOI: 10.3389/fcvm.2022.925211

65. Lu J, He Y, Terkeltaub R, Sun M, Ran Z, Xu X et al. Colchicine prophylaxis is associated with fewer gout flares after COVID-19 vaccination. Annals of the Rheumatic Diseases. 2022;81(8):1189–93. DOI: 10.1136/annrheumdis-2022-222199

66. Chidambaram V, Kumar A, Sadaf MI, Lu E, Al’Aref SJ, Tarun T et al. COVID-19 in the Initiation and Progression of Atherosclerosis: Pathophysiology During and Beyond the Acute Phase. JACC: Advances. 2024;3(8):101107. DOI: 10.1016/j.jacadv.2024.101107

67. Haslak F, Yildiz M, Adrovic A, Sahin S, Koker O, Aliyeva A et al. Management of childhood-onset autoinflammatory diseases during the COVID-19 pandemic. Rheumatology International. 2020;40(9):1423–31. DOI: 10.1007/s00296-020-04645-x

68. Ridker PM. Targeting residual inflammatory risk: The next frontier for atherosclerosis treatment and prevention. Vascular Pharmacology. 2023;153:107238. DOI: 10.1016/j.vph.2023.107238