Efficacy of low dose colchicine on left ventricular hypertrophy in patients with coronary artery disease: A
Ply Chichareon1, Ruedeekorn Suwannanon2, Metus Thungthienthong1
1Cardiology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Insights
Colchicine did not significantly reduce left ventricular mass in patients with coronary artery disease and hypertrophy. The study was underpowered due to early termination, making results inconclusive for this anti-inflammatory treatment.
Area of Science:
- Cardiology
- Pharmacology
- Inflammation Research
Background:
- Left ventricular hypertrophy (LVH) significantly increases adverse outcomes in coronary artery disease (CAD) patients.
- Inflammation is a key driver of LVH progression.
- Colchicine, an anti-inflammatory drug, was investigated for its potential to reduce LVH.
Purpose of the Study:
- To evaluate the efficacy of colchicine in reducing left ventricular mass in patients with CAD and LVH.
- To assess changes in left ventricular mass index (LVMI) as the primary endpoint.
Main Methods:
- A randomized trial involving 66 patients with CAD and LVH.
- Participants received either colchicine (0.6 mg daily) or placebo for 48 weeks.
- Left ventricular mass index (LVMI) was measured using cardiac magnetic resonance imaging.
Main Results:
- No significant difference in LVMI reduction was observed between the colchicine and placebo groups after 48 weeks.
- Changes in LVMI were -0.71 g/m² for colchicine vs. -1.28 g/m² for placebo (p=0.66).
- No significant changes were noted in other cardiovascular or metabolic markers.
Conclusions:
- Colchicine did not demonstrate a significant benefit over placebo in reducing LVMI in this patient cohort.
- Early study termination led to underpowering, rendering the results inconclusive.
- Further research is needed to determine if colchicine has a clinically meaningful effect on LVH.
Background:
Left ventricular hypertrophy (LVH) contributes to a substantial risk of adverse outcomes in patients with coronary artery disease (CAD). Inflammation is one of the mechanisms responsible for LVH progression. The study aimed to test the efficacy of colchicine, an anti-inflammatory agent, to reduce left ventricular mass in patients with CAD and LVH.
Methods:
Sixty-six patients with CAD, LVH and controlled blood pressure were randomly assigned to colchicine 0.6 mg daily or placebo for 48 weeks after a run-in period. The primary endpoint was changes in left ventricular mass index (LVMI) measured by cardiac magnetic resonance imaging.
Results:
After 48 weeks of treatment, the change in LVMI in the colchicine group was -0.71 g/m2 (interquartile range -6.51, 2.31) while it was -1.28 g/m2 (interquartile range -5.61, 5.50) in the placebo group. The absolute difference in the LVMI changes between the two groups was 0.57 g/m2 (95% confidence interval -5.61 to 4.1) with adjusted p value of 0.66. No significant differences in changes in left ventricular volume, left atrial volume, high-sensitivity C-reactive protein, insulin levels, haemoglobin A1c or body mass index were observed between the two groups.
Conclusion:
The study failed to demonstrate a treatment benefit of colchicine over placebo regarding LVMI reduction at 48 weeks. Given the early termination of the study, the results are inconclusive as the study was underpowered to detect small but potentially clinically meaningful differences.
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