Abstract P128: Reducing Inflammation In Coronary Atherosclerosis: A Renewed Look At Colchicine

Abstract

Introduction: Atherosclerosis is an inflammatory disease. Randomized controlled trials (RCT) have demonstrated that targeting inflammation is important for the secondary prevention of major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) and chronic coronary artery disease (CAD). Out of these trials, low-dose colchicine has emerged as an inexpensive therapy for coronary atherosclerosis. This meta-analysis focuses to understand colchicine’s anti-inflammatory efficacy via reduction in high sensitivity C-Reactive Protein (hs-CRP) in patients with ACS and CAD. Methods: A computerized search of MEDLINE was conducted to retrieve journal articles reporting the results in human studies performed from January 1, 2005 to January 1, 2021 using the keywords: “Colchicine” AND “Coronary” OR “CRP” OR “Coronary Artery Disease.” Studies were included if they measured hs-CRP changes from baseline and colchicine or placebo were given to patients with ACS or CAD. Studies were graded on quality via the Jadad scoring criteria. Results: A total of nine studies with a total population of 1502 patients and mean Jadad score of 4 were included in the meta-analysis. Five studies were RCT. The mean/median age ranged from 57 to 67 years while the duration of therapy ranged from one day to one year. Overall, colchicine treatment reduced hs-CRP levels compared with placebo (standardized mean difference [SMD]: -0.45; 95% CI: -0.68, -0.22; p=0.0001). Conclusion: Colchicine reduces hs-CRP in patients with ACS and CAD. This finding supports the role of colchicine in the reduction of inflammation associated with ACS or CAD. Further randomized control trials are needed to quantify long-term inflammatory control and subsequent MACE reduction.