TY - JOUR
T1 - Low-dose colchicine and high-sensitivity C-reactive protein after myocardial infarction
T2 - A combined analysis using individual patient data from the COLCOT and LoDoCo-MI studies
AU - Sun, Maxine
AU - Dubé, Marie Pierre
AU - Hennessy, Thomas
AU - Schultz, Carl J.
AU - Barhdadi, Amina
AU - Rhainds, David
AU - Hillis, Graham S.
AU - Tardif, Jean Claude
PY - 2022/9/15
Y1 - 2022/9/15
N2 - Background: Low-dose colchicine is effective in reducing the risks of recurrent cardiovascular events following an acute myocardial infarction (MI). However, the influence of colchicine on inflammation remains inconclusive. In the current study, we conducted a combined analysis using individual patient data from the COLCOT and LoDoCo-MI trials to assess the effect of low-dose colchicine on high-sensitivity C reactive protein (hs-CRP) in patients with acute MI. Methods: We performed a combined analysis of individual patient data from two clinical trials (COLCOT, LoDoCo-MI). Paired pre-treatment and post-treatment hs-CRP (mg/L) were available in 222 patients for LoDoCo-MI and 207 patients for COLCOT (npooled = 429). We evaluated the effect of colchicine vs. placebo on post-treatment hs-CRP coded continuously and ≤ 1.0 mg/L in adjusted mixed-model multi-level regression analyses. Results: Colchicine was not significantly associated with post-treatment hs-CRP when it was considered as a continuous variable (beta: -0.41, P = 0.429). However, the intervention was significantly associated with increased odds of achieving post-treatment hs-CRP values ≤1.0 mg/L compared to placebo (odds ratio: 1.64, 95% confidence interval: 1.07 to 2.51, P = 0.024). Conclusions: Reduction of inflammation may be a key component in the clinical efficacy of low-dose colchicine with respect to decreased risk of recurrent cardiovascular events following MI. Systematic sampling of hs-CRP before and after treatment with colchicine may be relevant.
AB - Background: Low-dose colchicine is effective in reducing the risks of recurrent cardiovascular events following an acute myocardial infarction (MI). However, the influence of colchicine on inflammation remains inconclusive. In the current study, we conducted a combined analysis using individual patient data from the COLCOT and LoDoCo-MI trials to assess the effect of low-dose colchicine on high-sensitivity C reactive protein (hs-CRP) in patients with acute MI. Methods: We performed a combined analysis of individual patient data from two clinical trials (COLCOT, LoDoCo-MI). Paired pre-treatment and post-treatment hs-CRP (mg/L) were available in 222 patients for LoDoCo-MI and 207 patients for COLCOT (npooled = 429). We evaluated the effect of colchicine vs. placebo on post-treatment hs-CRP coded continuously and ≤ 1.0 mg/L in adjusted mixed-model multi-level regression analyses. Results: Colchicine was not significantly associated with post-treatment hs-CRP when it was considered as a continuous variable (beta: -0.41, P = 0.429). However, the intervention was significantly associated with increased odds of achieving post-treatment hs-CRP values ≤1.0 mg/L compared to placebo (odds ratio: 1.64, 95% confidence interval: 1.07 to 2.51, P = 0.024). Conclusions: Reduction of inflammation may be a key component in the clinical efficacy of low-dose colchicine with respect to decreased risk of recurrent cardiovascular events following MI. Systematic sampling of hs-CRP before and after treatment with colchicine may be relevant.
KW - Colchicine
KW - High-sensitivity C reactive protein
KW - Inflammation
KW - meta-analysis
KW - Myocardial infarction
KW - NLRP3
UR - http://www.scopus.com/inward/record.url?scp=85132504997&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2022.06.028
DO - 10.1016/j.ijcard.2022.06.028
M3 - Article
C2 - 35716932
AN - SCOPUS:85132504997
SN - 0167-5273
VL - 363
SP - 20
EP - 22
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -