Related Experiment Video
Updated: May 10, 2025
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Role of Colchicine in Reducing Reperfusion Injury in STEMI Patients Who Undergo Primary Percutaneous Coronary
Birry Karim1, Idrus Alwi, Mohammad Yamin
11. Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. 2. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.. drbirrykarim@yahoo.co.id.
Insights
Colchicine did not reduce reperfusion injury (RI) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI). This randomized trial found no significant difference in RI events or side effects between colchicine and placebo groups.
Area of Science:
- Cardiology
- Pharmacology
- Inflammation Research
Background:
- Inflammation is implicated in ST-segment elevation myocardial infarction (STEMI) and reperfusion injury (RI).
- Colchicine, an anti-inflammatory agent, may mitigate inflammation during RI.
- Assessing colchicine's efficacy in STEMI patients undergoing primary percutaneous coronary intervention (PPCI) is crucial.
Purpose of the Study:
- To evaluate the effectiveness of colchicine in suppressing reperfusion injury (RI) events.
- To determine if colchicine impacts ischemia-RI incidence in STEMI patients undergoing PPCI.
- To compare the incidence of RI events and side effects between colchicine and placebo groups.
Main Methods:
- A multicenter, randomized, double-blind, placebo-controlled trial was conducted.
- STEMI patients undergoing PPCI received either colchicine (2 mg loading dose, 0.5 mg maintenance) or placebo.
- Patients were monitored for RI events, including low-flow TIMI, reperfusion arrhythmia, cardiogenic shock, and persistent chest pain.
Main Results:
- Colchicine failed to significantly reduce the incidence of ischemia-RI (51.5% vs. 42.4%, p=0.437).
- No statistical differences in RI were observed based on comorbidities or angiography results.
- Adverse event rates were comparable between the colchicine and placebo groups (21.6% vs. 15%).
Conclusions:
- Colchicine administration did not reduce reperfusion injury (RI) in STEMI patients undergoing PPCI.
- The study found no significant benefit of colchicine in preventing RI events in this patient population.
- Further research may be needed to explore alternative anti-inflammatory strategies for STEMI patients.
Background:
Inflammation plays a role in ST-segment elevation myocardial infarction (STEMI), especially in reperfusion injury (RI). Colchicine, an anti-inflammatory drug, can suppress inflammation during RI. We assessed the effectiveness of administering colchicine to STEMI patients undergoing primary percutaneous coronary intervention (PPCI) in suppressing RI events.
Methods:
This study was a randomized, double-blind, placebo-controlled clinical trial conducted in a multicenter manner at two hospitals in Jakarta with IKPP facilities from December 2022 to April 2023. STEMI patients that underwent PPCI received 2 mg of colchicine as a loading dose and a maintenance dose of 0.5 mg every 12 hours for two days or amylum at a similar dose. Patients were observed for RI events (low-flow thrombolysis in myocardial infarction (0-2) during angiography procedure, reperfusion arrhythmia, cardiogenic shock, or persistent chest pain).
Results:
Seventy-seven STEMI patients with a mean age of 55.2 ± 9.9 years underwent PPCI. Of these patients, 37 received colchicine, and 40 received a placebo. Most subjects were male (77.5%), suffered three-vessel disease (44.15%), and occlusion in left anterior descending coronary artery (53.24%). Colchicine was found to fail to reduce the incidence of ischemia-RI (51.5% vs. 42.4%; p = 0.437). Analysis of comorbidities (hypertension, chronic kidney disease, diabetes mellitus, and obesity) and angiography results (vessel disease, lesion diameter, and culprit artery) failed to demonstrate a statistical difference in RI. Side effects were similar in the colchicine and placebo groups (21.6% vs. 15%).
Conclusion:
Colchicine administration in STEMI patients undergoing PPCI failed to reduce RI.
Related Concept Videos
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins