Colchicine in Patients with Chronic Coronary Disease.
By S. Nidorf, A. Fiolet, A. Mosterd, J. Eikelboom, A. Schut, T. Opstal, Salem H K The, Xiao-fang Xu, M. Ireland, T. Lenderink and 23 more. New England Journal of Medicine, 2020
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BACKGROUND Evidence from a recent trial has shown that the antiinflammatory effects of colchicine reduce the risk of cardiovascular events in patients with recent myocardial infarction, but evidence of such a risk reduction in patients with chronic coronary disease is limited. METHODS In a randomized, controlled, double-blind trial, we assigned patients with chronic coronary disease to receive 0.5 mg of colchicine once daily or matching placebo. The primary end point was a composite of cardiovascular death, spontaneous (nonprocedural) myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization. The key secondary end point was a composite of cardiovascular death, spontaneous myocardial infarction, or ischemic stroke. RESULTS A total of 5522 patients underwent randomization; 2762 were assigned to the colchicine group and 2760 to the placebo group. The median duration of follow-up was 28.6 months. A primary end-point event occurred in 187 patients (6.8%) in the colchicine group and in 264 patients (9.6%) in the placebo group (incidence, 2.5 vs. 3.6 events per 100 person-years; hazard ratio, 0.69; 95% confidence interval [CI], 0.57 to 0.83; P<0.001). A key secondary end-point event occurred in 115 patients (4.2%) in the colchicine group and in 157 patients (5.7%) in the placebo group (incidence, 1.5 vs. 2.1 events per 100 person-years; hazard ratio, 0.72; 95% CI, 0.57 to 0.92; P = 0.007). The incidence rates of spontaneous myocardial infarction or ischemia-driven coronary revascularization (composite end point), cardiovascular death or spontaneous myocardial infarction (composite end point), ischemia-driven coronary revascularization, and spontaneous myocardial infarction were also significantly lower with colchicine than with placebo. The incidence of death from noncardiovascular causes was higher in the colchicine group than in the placebo group (incidence, 0.7 vs. 0.5 events per 100 person-years; hazard ratio, 1.51; 95% CI, 0.99 to 2.31). CONCLUSIONS In a randomized trial involving patients with chronic coronary disease, the risk of cardiovascular events was significantly lower among those who received 0.5 mg of colchicine once daily than among those who received placebo. (Funded by the National Health Medical Research Council of Australia and others; LoDoCo2 Australian New Zealand Clinical Trials Registry number, ACTRN12614000093684.).
Subfields: Cardiology and Cardiovascular Medicine, Immunology, Molecular Biology
View Paper: https://www.semanticscholar.org/paper/badfae1675c57f053c4945ee7ceb2b7cbb72fe93
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Citations in the corpus
- Targeting inflammation in atherosclerosis — from experimental insights to the clinic (2021, background): “5 mg/day) colchicine plus usual care or standard care plus placebo Reduction in cardiovascular events ACTRN12614000093684 (reF.(4))”
- Inflammation and atherosclerosis: signaling pathways and therapeutic intervention (2022, background): “and human biomarker and experimental work to clinical fruition.(355,366,378) Indeed, the recent evidence that interventions of anti-inflammation can forestall the complications of atherosclerosis scratches merely the surface of the potential as novel therapeutics.”