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Colchicine in Patients With Chronic Coronary Disease in Relation to Prior Acute Coronary Syndrome

Tjerk S J Opstal1, Aernoud T L Fiolet2, Amber van Broekhoven3

  • 1Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands.

Journal of the American College of Cardiology
|August 27, 2021
PubMed

Insights

Colchicine consistently reduces cardiovascular events in patients with chronic coronary disease, regardless of their history or the timing of previous acute coronary syndrome (ACS). This finding supports its use in secondary cardiovascular prevention.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Colchicine demonstrates efficacy in reducing cardiovascular events post-myocardial infarction and in chronic coronary disease.
  • The impact of treatment timing relative to acute coronary syndrome (ACS) on colchicine's benefits is not well-established.

Purpose of the Study:

  • To investigate major adverse cardiovascular events in relation to the history and timing of prior ACS.
  • To determine if colchicine's benefits are consistent across different prior ACS statuses.

Main Methods:

  • The LoDoCo2 trial randomized patients with chronic coronary disease to colchicine or placebo.
  • Analysis compared cardiovascular event rates based on prior ACS history: none, recent (6-24 months), remote (2-7 years), or very remote (>7 years).
  • Interaction between ACS status and colchicine treatment effect was assessed.

Main Results:

  • In 5,522 patients, colchicine consistently reduced the primary endpoint (cardiovascular death, myocardial infarction, stroke, revascularization) across all prior ACS groups.
  • Hazard ratios for colchicine vs. placebo ranged from 0.55 to 0.81, with no significant interaction (P=0.59).
  • Specific results showed reduced events in no prior ACS (HR 0.81), recent ACS (HR 0.75), remote ACS (HR 0.55), and very remote ACS (HR 0.70).

Conclusions:

  • Colchicine provides consistent cardiovascular benefits irrespective of the history and timing of prior acute coronary syndrome.
  • These findings support the use of colchicine for secondary prevention in patients with chronic coronary disease, regardless of their ACS timeline.
Abstract

Keywords:
anti-inflammatory agentsatherosclerosiscardiovascular inflammationischemic riskmyocardial infarctionsecondary prevention

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