Colchicine in Cardiology Practice: Use in Atrial Fibrillation, Inflammatory Diseases, Heart Failure, and Cardiac Complications of COVID-19

Inflammation is an integral part of the pathophysiological processes leading to damage or regeneration of the heart and blood vessels. Interest to the "inflammatory theory" of cardiovascular disease is once again at the peak of scientific research, driven by the discovery of new laboratory and instrumental methods, as well as the emergence of new cardiotropic viruses, including SARS-CoV-2. Colchicine, the most effective and safe drug used to modulate excessive inflammation in heart disease, is included in guidelines for the treatment of perimyocarditis and ischemic heart disease with a high class of evidence. Furthermore, it has been shown that colchicine can reduce the innate and, to some extent, the acquired immune response. Thereby, colchicine can affect the arrhythmia substrate and trigger, the inflammatory component of chronic myocardial degeneration during the development of heart failure. Also, colchicine can exert specific and nonspecific positive effects on the cardiac complications of COVID-19. The use of this medication in cardiology practice is limited by insufficient awareness of its indications and side effects, while in rheumatology practice, it is limited by a lack of knowledge about colchicine's additional properties in cardiac conditions. This review summarizes medical studies available online that assess the clinical efficacy of colchicine medicines in the conditions not yet included in official guidelines for its use, such as atrial fibrillation, autoinflammatory diseases, heart failure, and cardiac complications of COVID-19. For each of these conditions, colchicine can be used with the consideration of specific indications. This article includes published in the internet medical studies, abstracts, and meta-analyses with no publication date restrictions up to July 2025. The PubMed, ScienceDirect, Google Scholar, and CENTRAL databases were used to review 520 literature sources that described the clinical efficacy of colchicine medicines and the heterogeneity of its effects across different regimens for various cardiovascular diseases.