- For patients with recent myocardial infarction (MI), colchicine reduced risk for first (23%) and total ischemic cardiovascular (CV) events (34%) vs placebo.
Why this matters
- Inflammation contributes to atherosclerosis and its complications.
- Colchicine is an oral, widely available, potent anti-inflammatory drug, now shown to reduce risk for atherosclerotic events after recent MI.
- Patients ≤30 days post-MI receiving statins and antiplatelet agents (±other drugs).
- Groups well matched for age (60.5 years), demographics, CV history, time post-MI to randomization (13.5 days), medications.
- Percutaneous intervention completed if planned.
- Randomly assigned to colchicine 0.5 mg/day (n=2366) or placebo (n=2379).
- Canadian public funds and philanthropic foundations supported study.
- Primary composite endpoint: Time to cardiovascular death, first resuscitated cardiac arrest, MI, stroke, or urgent coronary revascularization.
- Follow-up, 42 months.
- Colchicine, 5.5% vs placebo, 7.1% (HR, 0.77; 95% CI, 0.61-0.96; P=.02).
- Statistically significant components of primary endpoint.
- Stroke: 0.2% vs 0.8%, respectively (HR, 0.26; 95% CI, 0.10-0.70).
- Urgent revascularization: 1.1% vs 2.1%, respectively (HR, 0.50; 95% CI, 0.31-0.81).
- Colchicine reduced total (first and recurrent) primary endpoint events by 34%.
- Low AE rates: no increased diarrhea with colchicine, but small increase in pneumonia, nausea, flatulence.
- Risks/benefits of treatment >23 months not evaluated.
- Larger trial required to better assess individual endpoints, subgroups, risks.
- Patients had recent MI; benefits of colchicine in other high-risk patients unknown.