Colchicine reduces ischemic events after MI

Colchicine reduces ischemic events after MI

Colchicine is potent anti-inflammatory agent which has been used in the treatment of gout, familial Mediterranean fever and pericarditis. A small study with 532 patients, which was not placebo controlled known as Low-Dose Colchicine (LoDoCo) trial evaluated 0.5 mg once daily in stable coronary artery disease [1]. The study documented a reduction in the primary outcome measure which was a composite of acute coronary syndrome, out-of-hospital cardiac arrest, or noncardioembolic ischemic stroke (p<0.001).

Now a bigger study, Colchicine Cardiovascular Outcomes Trial (COLCOT) which was placebo controlled and involving 4745 patients with recent myocardial infarction has been published in NEJM [2]. Though slightly higher risk of diarrhoea and pneumonia were noted in the study group, 0.5 mg daily of colchicine reduced ischemic cardiovascular endpoints significantly in those with recent myocardial infarction.

References

1. Nidorf SM, Eikelboom JW, Budgeon CA, Thompson PL. Low-dose colchicine for secondary prevention of cardiovascular disease. J Am Coll Cardiol. 2013 Jan 29;61(4):404-410.
2. Tardif JC, Kouz S, Waters DD, Bertrand OF, Diaz R, Maggioni AP, Pinto FJ, Ibrahim R, Gamra H, Kiwan GS, Berry C, López-Sendón J, Ostadal P, Koenig W, Angoulvant D, Grégoire JC, Lavoie MA, Dubé MP, Rhainds D, Provencher M, Blondeau L, Orfanos A, L’Allier PL, Guertin MC, Roubille F. Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction. N Engl J Med. 2019 Nov 16. doi: 10.1056/NEJMoa1912388. [Epub ahead of print]