Colchicine-treated familial mediterranean fever patients are associated with a lower prevalence of mitral annular calcification

Abstract

Objective: Inflammation contributes to mitral annular calcification (MAC). This study aimed to evaluate the relationship between MAC and colchicine-treated Familial Mediterranean Fever (FMF). Methods: This cross-sectional study included consecutively enrolled Familial Mediterranean Fever (FMF) patients (n = 98) receiving colchicine (≥ 1 mg/day for at least one year) and controls without FMF (n = 93). FMF was diagnosed according to the Tel-Hashomer criteria. MAC was defined by transthoracic echocardiography as an echogenic structure ≥ 5 mm in thickness located at the posterior mitral annulus. Demographic, clinical, and laboratory data were recorded. Factors associated with MAC were evaluated using univariate and multivariate logistic regression analyses. Results: Among 191 participants, 13 (6.8%) had MAC. Participants with MAC were older, had higher body mass index (BMI), and showed a higher prevalence of diabetes and hypertension compared with those without MAC (all p < 0.05). Multivariate logistic regression analysis demonstrated that age (OR = 1.06, 95% CI: 1.006–1.118), BMI (OR = 1.22, 95% CI: 1.074–1.391), and the presence of FMF (OR = 0.097, 95% CI: 0.012–0.778) were independently associated with MAC. FMF showed an inverse association with the presence of MAC. Receiver operating characteristic analysis demonstrated significant predictive value for age and BMI, while FMF showed an inverse discriminatory pattern (AUC = 0.266, p < 0.001). Conclusion: Colchicine-treated patients with Familial Mediterranean Fever may be associated with a lower prevalence of mitral annular calcification, suggesting a potential long-term cardiovascular protective effect through suppression of chronic inflammation.