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Colchicine Use and Risks of Stroke Recurrence in Acute Non-Cardiogenic Ischemic Stroke Patients: A Population-Based
Chi-Hung Liu1,2, Yu-Sheng Lin2,3, Pi-Shan Sung4
1Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
Insights
Recent colchicine use shows a marginal reduction in recurrent ischemic stroke (IS) risk for non-cardiogenic IS patients. Concurrent statin use may enhance these protective effects, suggesting a potential therapeutic benefit.
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- Colchicine is known for cardiovascular protective effects.
- The applicability of these effects to non-cardiogenic ischemic stroke (IS) patients requires investigation.
Purpose of the Study:
- To assess the impact of colchicine use on recurrent IS in non-cardiogenic IS patients.
- To compare outcomes between different colchicine usage patterns (new, long-term, former users, and non-users).
Main Methods:
- Retrospective cohort study using the National Health Insurance Research Database.
- Patients categorized into non-chronic (non-user, new user) and chronic (former user, long-term user) groups.
- Inverse probability of treatment weighting (IPTW) applied to balance baseline characteristics.
Main Results:
- New users of colchicine showed a marginally lower risk of recurrent IS at 6 months and 2 years.
- Long-term users also demonstrated a marginally reduced risk of recurrent IS.
- Concurrent statin use appeared to amplify the protective effects of colchicine.
Conclusions:
- Recent colchicine use is associated with a modest decrease in recurrent IS incidence in non-cardiogenic IS patients.
- Concurrent statin therapy may potentiate the benefits of colchicine in this patient population.
Abstract:
Background: The objective is to study whether the cardiovascular protective effects of colchicines could be applied to non-cardiogenic ischemic stroke (IS) patients. Patients and Methods: Non-cardiogenic IS patients were identified from the National Health Insurance Research Database. Eligible patients were divided into chronic and non-chronic use categories based on their long-term status of colchicine use. The non-chronic use category was subdivided into (1) non-user and (2) new user groups while the chronic use category was divided into (3) former user and (4) long-term user groups according to the patient's recent status of colchicine use. Inverse probability of treatment weights for propensity scores was used to balance the baseline characteristics. The primary outcome was recurrent IS, which was compared within the non-chronic use and chronic use categories. Results: In the non-chronic use category, the number of patients was 355,498 and 912 in the non-user and new user groups, respectively. In the chronic use category, the number of patients was 4737 and 4354 in the former user and long-term user groups, respectively. In the non-chronic use category, patients in the new user group had a marginally lower risk of recurrent IS at 6-months (subdistribution hazard ratio [SHR], 0.95; 95% confidence interval [CI], 0.94-0.97) and 2-years (SHR, 0.92; 95% CI, 0.91-0.93) follow up. In the chronic use category, patients in the long-term user group also had a marginally lower risk of recurrent IS at 6-months (SHR, 0.87; 95% CI, 0.86-0.88) and 2-years (SHR, 0.87; 95% CI, 0.86-0.88) follow up. The effect of colchicine on the reduced risk of recurrent IS was more favorable in patients who also used statins. Conclusions: Recent colchicine use in acute non-cardiogenic IS patients is associated with marginal fewer incidences of recurrent IS. Patients with concurrent statin use may have more profound protective effects.
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