In a nutshell
This trial was carried out to assess the use of colchicine (Colcrys) in reducing the risk of cardiovascular events (CVE) in patients who have chronic coronary artery disease (CAD). The trial found that the risk of CVE was significantly lower in patients who received colchicine when compared to placebo.
Some background
CAD happens when blood flow to the blood vessels that supply the heart is reduced or blocked. This can happen due to build-up of fat in the blood vesses or by stiffened blood vessels that can happen with age or uncontrolled blood pressure. Despite lifestyle changes and risk-factor reduction, patients with chronic CAD remain at risk of CVE such as heart attack, stroke or sudden death. Inflammation is thought to be a key process in the development of CAD.
Colchicine is an anti-inflammatory drug used in the treatment of gout. Colchicine is well tolerated at low doses. Previous trials have shown that colchicine reduces the risk of CVEs in patients who have recently had a heart attack. Evidence of a reduction in risk of CVE in patients with chronic CAD through the use of colchicine has yet to be uncovered.
Methods & findings
There were a total of 5522 patients with chronic CAD in this trial. 2762 were randomly assigned to receive colchicine 0.5mg once a day and 2760 received a placebo. The average follow-up was 28.6 months.
A CVE event occurred in 6.8% of patients in the colchicine group and 9.6% of the placebo group. The use of colchicine significantly reduced the risk of CVEs by 31%.
More patients in the colchicine group died from other causes than CVEs compared to the placebo group (by 51%).
The bottom line
The authors concluded that patients with chronic CAD who received 0.5mg colchicine once-daily experienced a reduction in the risk of developing a CVE.
The fine print
This trial did not report other factors that could affect CVEs such as inflammatory markers or fat levels in the blood.
Published By :
The New England Journal of Medicine
Date :
Aug 31, 2020
