If you have heart disease from clogged arteries, you know the constant worry about having another heart attack or needing another stent or bypass surgery. A new review of 11 major trials looked at whether adding a low dose of an old anti-inflammatory drug called colchicine could help. The analysis, which included data from over 30,000 people, found that colchicine was linked to a lower risk of major heart problems like heart attacks and strokes. Specifically, it reduced the overall risk of major heart events by 17% and the risk of events that also included procedures to open arteries by 23%. The benefit seemed to come mostly from preventing non-fatal events: it lowered the chance of having a heart attack and needing a coronary procedure. However, it did not reduce the risk of dying from heart disease or from other causes. The researchers conclude that colchicine reduces the risk of non-fatal events in people with heart disease, but more work is needed to figure out exactly which patients might benefit the most from adding it to their treatment plan.
Can an old anti-inflammatory drug help prevent heart attacks? A review of 11 trials suggests it might.
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What this means for you:
Colchicine may help prevent heart attacks and procedures in people with heart disease, but it doesn't lower the risk of death. What this means for you:
Colchicine may help prevent heart attacks and procedures in people with heart disease, but it doesn't lower the risk of death. View Original Abstract ↓
AIMS: Colchicine has recently been approved for the treatment of atherosclerotic cardiovascular disease (ASCVD). Since then, three large trials of colchicine in ASCVD have failed to reach their primary endpoints.
METHODS AND RESULTS: A systematic search of PubMed, Embase and Cochrane Central Register of Controlled Trials was performed (PROSPERO registration: CRD42024616378). The primary endpoint of major adverse cardiovascular events (MACE) was defined as a composite of myocardial infarction (MI), stroke and cardiovascular death. The key secondary endpoint of extended MACE (eMACE) was defined as MACE plus coronary revascularisation. Pooled estimates were calculated using a random-effects model and are presented as risk ratio [95% confidence interval (CI)]. 1624 articles were screened. 12 met inclusion criteria, yet one trial reported zero endpoint events in both arms. As such, 11 trials were included in the meta-analysis, with a total of 1983 primary endpoint events across 30 808 participants. Colchicine was associated with a 17% reduction in the incidence of MACE [0.83 (0.73, 0.95); P = 0.006] and 23% reduction in the incidence of eMACE [0.77 (0.63, 0.94); P = 0.01]. This reduction was driven by a lower rate of MI [0.78 (0.63, 0.95); P = 0.02] and coronary revascularisation [0.73 (0.55, 0.97); P = 0.03]. There were also numerically fewer strokes in the colchicine-treated population [0.81 (0.63, 1.04); P = 0.11]. Colchicine had no effect on cardiovascular [0.96 (0.79, 1.15); P = 0.64] or non-cardiovascular mortality [1.04 (0.76, 1.41); P = 0.81].
CONCLUSION: Colchicine reduces the risk of non-fatal ischaemic events in patients with ASCVD. Further studies are required to identify a population(s) who stands to benefit most from this promising therapy.