Table 4.
Studies on colchicine for the prevention of acute coronary syndromes
| Study | Study design | Dosing | Clinical setting | Patients | Main results |
|---|---|---|---|---|---|
| Raju et al.29w (2012) | Double-blind RCT | Colchicine 1.0 mg daily for 1 month | ACS or stroke | 82 | Failure to reduce hs-CRP at 30 days (median 1.0 mg/l vs. 1.5 mg/l, P = 0.22) |
| Deftereos et al.31w (2015) | Double-blind RCT | Loading dose of 2 mg followed by 0.5 mg twice daily for 5 days | STEMI | 151 | Reduction of CK-MB plasma concentration (3144 ng/mL vs. 6184 ng/mL, P < 0.01) and infarct size by magnetic resonance imaging (18.3 mL/1.73 m2 vs. 23.2 mL/1.73 m2, P = 0.02) |
| Akodad et al.30w (2017) | Prospective study | Colchicine 1 mg once daily plus OMT for 1 month | STEMI | 44 | Failure to reduce CRP peak value during the index hospitalization (29.03 mg/L vs. 21.86 mg/L, P = 0.36), even after adjustment for the culprit artery (27 mg/L vs. 25 mg/L, P = 0.79) |
| Vaidya et al.32w (2018) | Prospective study | Colchicine 0.5 mg daily plus OMT for 12 months | Recent ACS (<1 month) | 80 | Reduction of LAPV (15.9 mm3 vs. 6.6 mm3, P = 0.008) and hs-CRP (1.10 mg/L vs. 0.38 mg/L, P < 0.01) |
| COLCOT trial44 (2019) | Double- blind RCT | Colchicine 0.5 mg daily for a median of 20 months | Recent myocardial infarction (<1 month) | 4745 | Reduction of CV events (composite of CV death, cardiac arrest, myocardial infarction, stroke, or urgent hospitalizations for angina): 5.5% vs. 7.1% (HR 0.77, 95% CI 0.61–0.96) |
| COLCHICINE-PCI46 (2020) | Double-blind RCT | Preprocedural oral administration of 1.8 mg of colchicine | 50% patients with an ACS | 400 | The primary outcome of PCI-related myocardial injury did not differ between colchicine (n = 206) and placebo (n = 194) groups (57.3% vs. 64.2%, P = 0.19) |
| COPS trial47 (2020) | Double-blind RCT | Colchicine 0.5 mg twice daily for the first month, then 0.5 mg daily | ACS | 795 |
The primary outcome of all-cause mortality, ACS, ischaemia-driven (unplanned) urgent revascularization, and non-cardioembolic ischaemic stroke did not differ between colchicine (n = 396) and placebo (n = 399): 24 vs. 38 events (P = 0.09) The composite of CV death, ACS, stroke and unplanned revascularization 0.54 (0.29–0.99) |
ACS, acute coronary syndrome; CK-MB, creatine kinase-myocardial brain fraction; CV, cardiovascular; HR, hazard ratio; hs-CRP, high-sensitivity C-reactive protein; LAPV, low attenuation plaque volume; OMT, optimal medical therapy; PCI, percutaneous coronary intervention; RCT, randomized controlled trial; STEMI, ST-elevation myocardial infarction.