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Colchicine for acute and chronic coronary syndromes
  1. Massimo Imazio1,2,
  2. Alessandro Andreis3,
  3. Antonio Brucato4,
  4. Yehuda Adler5,
  5. Gaetano Maria De Ferrari6
  1. 1University Cardiology, AOU Città della Salute e della Scienza di Torino, Torino, Italy
  2. 2Department of Public Health and Pediatrics, University of Torino, Torino, Italy
  3. 3University Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino, Torino, Italy
  4. 4Department of Biomedical and Clinical Sciences, Fatebenefratelli Hospital and University of Milano, Milano, Italy
  5. 5College of Law and Business, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan And Tel Aviv, Israel
  6. 6University Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino and University of Torino, Torino, Italy
  1. Correspondence to Professor Massimo Imazio, University Cardiology, AOU Città della Salute e della Scienza di Torino, Torino 10126, Italy; massimo_imazio{at}yahoo.it

Abstract

Colchicine is an ancient drug, traditionally used for the treatment and prevention of gouty attacks; it has become standard of treatment for pericarditis with a potential role in the treatment of coronary artery disease. Atherosclerotic plaque formation, progression, destabilisation and rupture are influenced by active proinflammatory cytokines interleukin (IL)-1β and IL-18 that are generated in the active forms by inflammasomes, which are cytosolic multiprotein oligomers of the innate immune system responsible for the activation of inflammatory responses. Colchicine has a unique anti-inflammatory mechanism: it is not only able to concentrate in leucocytes, especially neutrophils, and block tubulin polymerisation, affecting the microtubules assembly, but also inhibits (NOD)-like receptor protein 3 (NLRP3) inflammasome. On this basis, colchicine interferes with several functions of leucocytes and the assembly and activation of the inflammasome as well, reducing the production of interleukin 1β and interleukin 18. Long-term use of colchicine has been associated with a reduced rate of cardiovascular events both in chronic and acute coronary syndromes, with an overall good safety profile. This review will focus on the influence of colchicine on the pathophysiology of coronary artery disease, reviewing essential pharmacology and discussing the most important and recent clinical studies. On the basis of current literature, colchicine is emerging as a possible new valuable, safe and cheap agent for the treatment of acute and chronic coronary syndromes.

  • coronary artery disease
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Footnotes

  • Contributors All authors have contributed, reviewed and approved the final submitted manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Author note Twitter: @ImazioMassimo

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