The Carb Addiction Doc on Colchicine vs. statins

I follow Dr. Rob Cywes, the Carb Addiction Doc for another viewpoint on heart and glucose health. This latest video is a bit of an eye opener for me because my wife was put on colchicine for about 8 weeks before she consulted a rheumatologist who promptly took her off it. I haven't seen my wife more energetic or feeling well, and very much her ol' self, than about four weeks into the 8 week span on colchicine. Also, it was the link to pulmonary vein energizing and AF that caught my ear. Take this for what it's worth to you:

[www.youtube.com]

This was a fascinating video for me. I had never heard of Colchicine before I got Pericarditis, but have long known about the Cholesterol/Inflammation connection. I had just stopped taking the Colchicine after my Pericarditis and then got Vasculitis and am back on it. I had already contemplated being on it longer term because I obviously have a huge propensity towards systemic inflammation. This video kind of cinched it for me. I will be talking with my Cardiologist/Integrative Med doc this week. Great video!

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gloaming
Also, it was the link to pulmonary vein energizing and AF that caught my ear.

Very interesting! Thanks Gloaming!

Rob Cywes, unfortunately, appears a bit surly for much of his presentation. He doesn't come across as a happy camper, rarely smiles....but...he has been through the wringer himself and is in 'recovery' for his own carb addiction. He's a zealous man who has made it his mission to reach millions and to help them to beat their addiction, to lose weight, to reduce inflammation and pre-metabolic syndrome (or full-blown metabolic syndrome if they're in it), and to stay off all possible medications. This last one, to abstain from statins if possible, is the last episode in a series about statins.

Is there any anyone who has had success with colchicine stoping their Afib.
I have never heard of anyone.

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colindo
Is there any anyone who has had success with colchicine stoping their Afib.
I have never heard of anyone.

Looks like it may be beneficial in post surgical cases.

Source

The Effect of Colchicine on Atrial Fibrillation: A Systematic Review and Meta-Analysis

Abstract
Colchicine is a potent anti-inflammatory agent whose benefits have been explored for various conditions, including atrial fibrillation (AF). In this article, we tried to understand why colchicine might be beneficial in AF and reviewed various studies that looked at the effect of colchicine against AF. We followed the PRISMA algorithm and undertook a literature search to identify studies with control groups that looked at the effect of colchicine against AF and conducted a meta-analysis. We identified six studies on post-cardiac surgical patients, three on post-pulmonary vein isolation (PVI)/ablation patients, and two on coronary artery disease. In patients who underwent cardiac surgery, we found that colchicine is beneficial against postoperative atrial fibrillation (POAF) with a relative risk (RR) of 0.70 (95% CI of 0.58 to 0.84) and a p-value of 0.0001. We also found that in patients who underwent PVI/ablation, colchicine is beneficial in decreasing AF recurrence over three months with an RR of 0.57 (95% CI of 0.39 to 0.83) and a p-value of 0.0032 and over 12 months follow-up with an RR of 0.58 (95% CI of 0.42 - 0.80) and a p-value of 0.0008. Our meta-analysis showed that in patients with coronary artery disease, colchicine had no significant benefit in decreasing the incidence of AF with a hazard ratio (HR) of 0.86 (95% CI of 0.69 - 1.06) and a p-value of 0.16. From this study, we conclude that colchicine may be beneficial for decreasing the incidence of AF in post-cardiac surgery patients and post-PVI/ablation patients. It may not decrease the incidence of AF in patients with coronary artery disease.

I wonder what the demarcation point is for 'coronary artery disease'. Is the criterion solely a formal diagnosis (yes/no, or binary) or is it an assessment of a certain percentage of occlusion in one or more arteries? All my tests prior to my first ablation were to pinpoint locations of ischemia, as admitted by my prescribing cardiologist. In fact, he repeated this to me and doubled my statin dose at one point. This was just prior to my second MIBI stress test with radio-opaque dye injected to spot the narrowings. None of the tests, multiple X-rays, MRI, angiogram, Doppler of the carotid arteries...none...showed anything remarkable or worth mentioning to me, including when I challenged my own family GP about why I was on statins. The screening cardiologist/EP understudy of Dr. Novak snorted when I pointed out that I was apparently quite clean, and said, 'Oh no, you DO have heart disease.' Okay, is this at the 40%ile, 60th, 85th....what the hell are we talking about here. I got no answer.

So, I would like to understand what the authors mean by 'coronary artery disease'. Is it the slightest indication of plaque...somewhere...anywhere...or are we talking about 40% occlusion and up?

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gloaming
So, I would like to understand what the authors mean by 'coronary artery disease'. Is it the slightest indication of plaque...somewhere...anywhere...or are we talking about 40% occlusion and up?

The only indication of CAD I've ever gotten was a description of "mild aortic plaque" from one TEE (I've had others, but only one TEE ever mentioned it). That was sufficient to get me in the Watchman FLX clinical trials because they required a CHADS-Vasc of 3+. My EP at the time (Natale) and I had always considered myself a 2 for 65+ and HTN, but he successfully used that one report to get me included after the research team rejected me as a CHADS-Vasc 2.

So the answer is any plaque at all means you have CAD. The thing is, virtually every single person over 65 has at least some detectable plaque, so take it for what it's worth. If you really want an assessment, get a calcium score.



Edited 2 time(s). Last edit at 07/19/2024 05:16AM by Carey.

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gloaming
So, I would like to understand what the authors mean by 'coronary artery disease'. Is it the slightest indication of plaque...somewhere...anywhere...or are we talking about 40% occlusion and up?

This seems to be the one referenced study that looked at the question you are asking.

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Trial Population
Patients 35 to 82 years of age were eligible if they had any evidence of coronary disease on invasive coronary angiography or computed tomography angiography or a coronary-artery calcium score of at least 400 Agatston units on a coronary-artery calcium scan. Patients were required to have been in a clinically stable condition for at least 6 months before enrollment. Patients were not eligible if they had moderate-to-severe renal impairment, severe heart failure, severe valvular heart disease, or known side effects from colchicine. Renal function was defined on the basis of the Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Acute Kidney Injury.

Thanks to both of you. I suppose that will have to be it; if any is detected, you have it.

Yeah, pretty much, but how significant it is for you is a different question.

I've taken Colchicine for gout and it cleared it up quickly. Shortly after that a Pharma petitioned the FDA to do a study to see if Colchicine was safe and the FDA approved the petition. This gave that particular Pharma the rights for a "new drug": Colcrys (only over 3000 years of use). The result was: Colcrys became the only FDA-approved colchicine product on the market, the price skyrocketed to around $5 per tablet, making it 50 times more expensive than the generic versions previously available, the study concluded. Of course, unless you are close enough to buy generic Colchicine in Canada.

... disgusting.

At any rate, an OUTSTANDING video... thank you.

So glad to be introduced to this video and Dr. Cywes, Gloaming. Thanks.