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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EPostoperative pericardial effusion (POPE) is present within the first 7 days after cardiac surgery in 50% to 80% of patients, and the risk for early cardiac tamponade ranges from 0.5% to 1%. There is no drug that can treat this local hemorrhagic complication. The Colchicine Treatment for Post-operative Pericardial Effusion [POPE-2; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01266694\u0026amp;atom=%2Fspmdc%2F14%2F27%2F15.1.atom\u0022\u003ENCT01266694\u003C\/a\u003E] was a double-blind, placebo-controlled study to evaluate whether COL could reduce the volume of POPE.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInflammatory Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInflammatory Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EPostoperative pericardial effusion (POPE) is present within the first 7 days after cardiac surgery in 50% to 80% of patients, and the risk for early cardiac tamponade ranges from 0.5% to 1%. There is no drug that can treat this local hemorrhagic complication, stated Philippe Meurin, MD, Les Grands Pr\u00e9s, Villeneuve Saint Denis, France. From day 8, patients with POPE are at risk for persistence of the effusion, with the risk for tamponade dependent on its size. Although nonsteroidal anti-inflammatory drugs do not reduce persistent POPE, it is unknown whether the anti-inflammatory drug colchicine (COL) might be effective. COL has been shown to be effective in treating other pericardial conditions, including acute pericarditis [Imazio M et al. \u003Cem\u003EN Engl J Med.\u003C\/em\u003E 2013] and postpericardiotomy syndrome [Imazio M et al. \u003Cem\u003EEur Heart J.\u003C\/em\u003E 2010].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe Colchicine Treatment for Post-operative Pericardial Effusion [POPE-2; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01266694\u0026amp;atom=%2Fspmdc%2F14%2F27%2F15.1.atom\u0022\u003ENCT01266694\u003C\/a\u003E] was a double-blind, placebo-controlled study to evaluate whether COL could reduce the volume of POPE. Conducted at 10 cardiac rehabilitation centers in France, the trial randomized 197 patients with moderate to large pericardial effusion (ie, grades II, III, and IV) on admission echocardiography (8 to 30 days after surgery) to a 14-day treatment course of placebo (n = 99) or COL (n = 99). The dose of COL was adjusted according to patient weight; all patients received 1 mg\/day, except those who weighed \u2265 70 kg, who received an additional 1 mg on day 1. The primary end point was the change in mean pericardial effusion grade (MPEG) in the COL arm relative to placebo.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe patients has a mean age of 65 years, and most were men, 89% and 84% of the placebo and COL groups, respectively. At baseline, both groups were similar for the proportion of patients with grade II, III, and IV effusions and for MPEG.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe difference in the reduction of MPEG between the arms was not significant (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14977\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14977\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14977\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EPrimary End Point of Decrease in Mean Pericardial Effusion Grade\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EDevelopment of cardiac tamponade after 14 days of treatment did not significantly differ (log-rank \u003Cem\u003EP\u003C\/em\u003E = .801) between the arms; neither did the requirement for pericardial drainage within 6 months (lo g-rank \u003Cem\u003EP\u003C\/em\u003E = .202). The proportion of patients who had a \u2265 1-MPEG decrease was nonsignificant between the arms (67% and 74% of the placebo and COL groups, respectively; \u003Cem\u003EP\u003C\/em\u003E = .27), as was the presence of atrial fibrillation at the end of the study (12% and 15%, respectively; \u003Cem\u003EP\u003C\/em\u003E = .51). The reductions in the width of the echo-free space were similar at \u22124.7 and \u22125.8 mm in the placebo and COL groups, respectively (\u003Cem\u003EP\u003C\/em\u003E = .23).\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EFurthermore, no difference was found with COL in any of the prespecified subgroups, including C-reactive protein level \u2265 30 mg\/L and receiving an oral anticoagulant or in the per protocol analysis.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EThe POPE-2 study confirmed that a moderate to large POPE persisting \u0026gt; 7 days is a serious condition, with cardiac tamponade occurring in 13 patients (6.6%) and pericardial drainage within 6 months occurring in 22 patients (11.2%) across both arms. COL did not provide any benefit either by echocardiography or on clinical events.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/27\/15.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzou4p\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzou4p\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}