Table 2

Clinical studies assessing the use of colchicine in patients with ACS

Study, year*Study designColchicine dose and durationClinical settingPatient numberMain results
Tardif et al (COLCOT trial)48 Randomised trialColchicine 0.5 mg daily for a median of 20 monthsRecent myocardial infarction (<1 month)4745Colchicine reduced ischaemic cardiovascular events (composite of cardiovascular death, cardiac arrest, myocardial infarction, stroke or urgent hospitalisations for angina): 5.5% vs 7.1% (HR 0.77, 95% CI 0.61 to 0.96).
Vaidya et al 34 Prospective studyColchicine 0.5 mg daily plus OMT for 12 monthsRecent ACS (<1 month)80Colchicine reduced LAPV (15.9 mm3 vs 6.6 mm3, p=0.008) and hs-CRP (1.10 mg/L vs 0.38 mg/L, p<0.001).
Akodad et al 46 Prospective studyColchicine 1 mg once daily plus OMT for 1 monthSTEMI44No significant difference in CRP peak value during the index hospitalisation (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).
Solomon et al 44 Retrospective studyPrevalence of myocardial infarction, stroke, transient ischaemic attack in patients with gout1002Prevalence of myocardial infarction was reduced (HR 0.51, 95% CI 0.30 to 0.88) in patients receiving colchicine.
Deftereos et al 47 Randomised trialLoading dose of 2 mg followed by 0.5 mg twice daily for 5 daysSTEMI151Colchicine reduced CK-Mb plasmatic concentration (3144 ng/mL vs 6184 ng/mL, p<0.001) and infarct size by MRI (18.3 mL/1.73 m2 vs 23.2 mL/1.73 m2, p=0.019).
Raju et al 45 Randomised trialColchicine 1.0 mg daily for 1 monthPatients with ACS or stroke82Colchicine did not reduce hs-CRP at 30 days (median 1.0 mg/L vs 1.5 mg/L, p=0.22).
Crittenden et al 43 Cross-sectional studyPrevalence of myocardial infarction in patients with gout1288Prevalence of myocardial infarction was lower in patients receiving colchicine for gout (1.2% vs 2.6%, p=0.03).
  • *From most recent studies.

  • ACS, acute coronary syndrome; CK-Mb, creatine kinase-myocardial brain fraction; COLCOT, Colchicine Cardiovascular Outcomes Trial; CRP, C reactive protein; LAPV, low-attenuation plaque volume; OMT, optimal medical therapy; STEMI, ST-elevation myocardial infarction.