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Low-Dose Colchicine for Secondary Prevention in Patients With Chronic Coronary Syndrome: A Multicenter Real-World
Ecem Gürses1, Mustafa Doğduş2, Umut Uyan3
1Department of Cardiology, Bakırçay University Çiğli Training and Research Hospital, İzmir, Turkey.
Insights
Low-dose colchicine significantly improved functional capacity and reduced angina symptoms in patients with chronic coronary syndrome (CCS). This real-world study found colchicine to be a safe and effective adjunctive therapy for secondary prevention and symptom management.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Chronic coronary syndrome (CCS) patients experience persistent symptoms and reduced quality of life despite standard treatments.
- Low-dose colchicine shows promise in randomized trials, but real-world data on its impact on CCS functional capacity and angina is limited.
Purpose of the Study:
- To evaluate the real-world effectiveness of low-dose colchicine in improving functional capacity and angina-related outcomes in CCS patients.
- To assess the safety and tolerability of low-dose colchicine for secondary prevention in a large, multicenter cohort.
Main Methods:
- A multicenter, real-world observational study involving 614 CCS patients receiving low-dose colchicine for secondary prevention.
- Assessment of functional capacity and quality of life using the Seattle Angina Questionnaire (SAQ) pre- and post-treatment.
- Evaluation of changes in physical activity, angina frequency, nitroglycerin use, treatment satisfaction, CCS angina class, clinical outcomes, and adverse events.
Main Results:
- Colchicine therapy led to significant improvements in functional capacity (walking, household activities, heavy object carrying) and reduced angina frequency and nitroglycerin use (all p < 0.001).
- Patient-reported outcomes showed increased treatment satisfaction and decreased life enjoyment limitations (p < 0.001), with a decrease in CCS angina class.
- A clinically meaningful improvement in SAQ score was achieved by 78.7% of patients; hospitalization (9.0%), revascularization (4.4%), and GI adverse effects (9.4%) were reported.
Conclusions:
- Low-dose colchicine therapy in a real-world CCS cohort demonstrated significant improvements in functional capacity, angina severity, and quality of life.
- The therapy exhibited an acceptable safety profile, with a high rate of clinically meaningful patient-reported improvements.
- Colchicine is supported as an effective adjunctive therapy for secondary prevention and symptom control in routine clinical practice for CCS.
Aims:
Chronic coronary syndrome (CCS) remains associated with recurrent ischemic symptoms and impaired quality of life despite contemporary guideline-directed medical therapy. Low-dose colchicine has demonstrated prognostic benefits in randomized trials; however, real-world data regarding its effects on functional capacity and angina-related outcomes are limited.
Methods:
This multicenter, real-world observational study included 614 patients with CCS receiving low-dose colchicine therapy for secondary prevention. Functional capacity and angina-related quality of life were assessed before and after colchicine treatment using the Seattle Angina Questionnaire. Changes in daily physical activities, angina frequency, nitroglycerin use, treatment satisfaction, and Canadian Cardiovascular Society (CCS) angina class were evaluated. Clinical outcomes and tolerability, including hospitalization, revascularization, and gastrointestinal adverse effects, were also analyzed. A clinically meaningful improvement was defined as a ≥ 10-point increase in the composite Seattle Angina Questionnaire score.
Results:
The mean age of the study population was 68.8 ± 11.5 years, and 70.5% of patients were male. Following colchicine therapy, significant improvements were observed in functional capacity, including walking on level ground, household activities, and carrying heavy objects (all p < 0.001). Angina frequency scores improved, accompanied by reduced nitroglycerin use (p < 0.001). Treatment satisfaction increased and limitations in enjoyment of life decreased significantly (p < 0.001). CCS angina class decreased from 2.61 ± 0.7 to 1.4 ± 0.62 (p < 0.001). A clinically meaningful improvement in SAQ score was observed in 78.7% of patients. During follow-up, hospitalization occurred in 9.0% of patients, revascularization in 4.4%, and gastrointestinal adverse effects were reported in 9.4%.
Conclusions:
In a multicenter real-world cohort of patients with chronic coronary syndrome, low-dose colchicine therapy was associated with significant improvements in functional capacity, angina severity, and quality of life, with an acceptable safety profile. The high rate of clinically meaningful patient-reported improvement further supports colchicine as an effective adjunctive therapy for secondary prevention and symptom control in routine clinical practice.
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