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Colchicine Use and Major Adverse Cardiovascular Events in Male Patients with Gout and Established Coronary Artery

Gary H Ho1,2, Michael Toprover1,2, Daria B Crittenden1,2

  • 1Rheumatology Section, Department of Medicine, Margaret Cochran Corbin Campus of the New York Harbor Health Care System, United States Department of Veterans Affairs, New York, NY 10010, USA.

Gout, Urate, and Crystal Deposition Disease
|August 18, 2026
PubMed

Insights

Colchicine use in gout patients with coronary artery disease (CAD) did not increase major adverse cardiovascular events (MACE). Consistent colchicine use was associated with lower MACE risk, suggesting maintenance of bloodstream levels is key for cardiovascular protection.

Area of Science:

  • Cardiology
  • Rheumatology
  • Pharmacology

Background:

  • Colchicine is effective for gout but its cardiovascular safety in high-risk patients is unclear.
  • Patients with gout and coronary artery disease (CAD) represent a population with elevated cardiovascular risk.
  • The impact of colchicine on major adverse cardiovascular events (MACE) in gout patients with CAD needs evaluation.

Purpose of the Study:

  • To assess the association between colchicine use and MACE in gout patients who have pre-existing CAD.
  • To determine if colchicine influences cardiovascular event risk in this specific patient group.

Main Methods:

  • Retrospective cohort study of gout patients with established CAD within the VA system.
  • Comparison of MACE rates between regular colchicine users (>30 days prescription with refill) and nonusers.
  • Analysis of MACE within the colchicine group based on consistency of use (quartiles).

Main Results:

  • No significant difference in MACE was observed between any colchicine use and nonuse (OR 1.14).
  • Colchicine users had a higher baseline cardiovascular risk, potentially balancing the observed odds.
  • Highest quartile of continuous colchicine use (>70% time) showed significantly lower MACE odds (OR 0.35; p=0.01).

Conclusions:

  • Colchicine use in gout patients with CAD did not elevate MACE risk despite higher baseline CV risk.
  • Consistent colchicine use was linked to reduced MACE, with lower event rates during active use periods.
  • Maintaining consistent colchicine bloodstream levels may be crucial for achieving cardiovascular protection.
Abstract

Keywords:
cardiovascular riskcolchicinegoutmajor adverse cardiovascular events

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