Inflammation plays a major role in the complications and clinical manifestations of acute coronary syndrome (ACS). Colchicine is an often used treatment for gout, and has recently emerged as a therapeutic option in cardiovascular medicine attributed to its anti-inflammatory properties. This test was a double-blind, multicenter, placebo-controlled trial involving seventeen hospitals that provided acute cardiac care services. The eligible participants were adults, aged between 18–85 years, presented with ACS and had evidence of coronary artery disease on coronary angiography managed with either medical therapy or percutaneous coronary intervention. The patients were administered colchicine or placebo, in addition to the secondary prevention pharmacotherapy.
The primary outcome consisted of mortality due to all causes, noncardioembolic ischemic stroke, ischemia-driven revascularization, and ACS in a time to event analysis. Seven hundred ninety-five patients were recruited between 2015 – 2018 (mean age, 60 years; 21% female), with 399 to the placebo group and 396 assigned to the colchicine group. Over the 12-month follow-up, 38 events in the placebo group were compared with 24 events in the colchicine group. There was a higher death rate (8 vs. 1) in noncardiovascular death in the colchicine group. The rates of reported adverse effects were similar (placebo 24.3% vs. colchicine 23%), and they were predominantly gastrointestinal symptoms (placebo, 20.8% and colchicine 23% ).
In conclusion, the addition of colchicine to standard medical therapy did not affect cardiovascular outcomes significantly at 12 months in patients with ACS and was also associated with a higher mortality rate.
Ref: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.050771
