Colchicine likely curbs MACE risk regardless of history, timing of prior acute coronary syndrome

Reuters Health - 26/08/2021 - Colchicine reduced the risk of major adverse cardiovascular events (MACEs) after a heart attack and in patients with chronic coronary syndrome (ACS), regardless of history or timing of prior ACS, a secondary analysis of the LoDoCo2 study shows.

The LoDoCo2 (Low-Dose Colchicine 2) trial (https://bit.ly/3sLckai) found in 2020 that the risk of MACE was significantly lower with 0.5 mg colchicine daily versus placebo.

As reported now in the Journal of the American College of Cardiology, Dr. Tjerk S.J. Opstal of Radboud University Medical Center in Nijmegen, the Netherlands and colleagues analyzed data from LoDoCo2 to determine whether the benefits of colchicine are consistent independent of prior ACS status.

They compared the rate of the composite of cardiovascular death, spontaneous myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization between patients with no prior, recent (6-24 months), remote (2-7 years), or very remote (>7 years) ACS.

The analysis showed that among 5,522 randomized patients followed for a median of 28.6 months, the risk of the primary endpoint was independent of prior ACS status.

Compared with placebo, colchicine consistently reduced the primary endpoint in patients with no prior ACS (incidence: 2.8 vs. 3.4 events per 100 person years; hazard ratio, 0.81) and across subgroups of patients with recent ACS (2.4 vs. 3.3 events per 100 p-yrs; HR, 0.75); remote ACS (1.8 vs. 3.2 events per 100 p-yrs; HR, 0.55); and very remote ACS (3.0 vs. 4.3 events per 100 p-yrs; HR, 0.70).

In an editorial, Drs. Jean-Claude Tardif and Guillaume Marquis-Gravel of the University of Montreal write, "Low-dose colchicine reduces the risk of ischemic cardiovascular events on a background of excellent standard care, irrespective of whether the patient has had a myocardial infarction or presents with stable coronary artery disease...inflammation reduction with low-dose colchicine should be considered to treat patients with coronary disease in the absence of severe renal dysfunction."

The study was funded in part by a consortium of Teva, Disphar, and Tiofarma in the Netherlands.

SOURCE: https://bit.ly/3yiobxJ and https://bit.ly/3jhB7zS Journal of the American College of Cardiology, online August 23, 2021.

By Marilynn Larkin



Posted on 26 August, 20212 September, 2021