Abstract 13979: Meta-Analysis of Efficacy and Safety of Colchicine Therapy in Patients With Acute Coronary Syndrome

Abstract

Introduction: Colchicine is known to be effective in treatment of inflammatory disorders, however, the effects of colchicine in patients with acute coronary syndrome (ACS) on top of background standard medical therapy remains uncertain. Hypothesis: There is paucity of data about colchicine therapy in patients presenting with acute coronary syndrome which may be associated with significant reduction in cardiovascular events. Methods: Six randomized controlled trials reporting CV outcomes in patients with acute coronary syndrome were included in MEDELINE, EMBASE and CENTRAL database (Inception to May 2021). The outcome measures were the summary random effects risk ratio (RR) with 95% confidence intervals. Results: In 6282 patients presenting with ACS, colchicine therapy did not significantly reduce the risk of all-cause mortality (RR, 1.62 [0.45, 5.88], P=0.87) or CV mortality (RR, 0.98 [0.43, 2.25], P=0.97) or myocardial infarction (MI) (RR, 0.88 [0.69, 1.11], P=0.28). Colchicine therapy had a significant effect on Major adverse cardiovascular events (MACE) (RR, 0.79 [0.64, 0.97], P=0.02), Stroke (RR, 0.33 [0.15, 0.72], P=0.01), and revascularization (RR, 0.46 [0.29, 0.73], P<0.01). In comparison to control, colchicine had significantly higher rate of GI side effects (RR, 1.53 [1.05, 2.23], P=0.03) Conclusions: Colchicine therapy in patients presenting with acute coronary syndrome was associated with significant reduction in MACE, stroke and revascularization at the cost of higher rate of GI side effects.