AHA 2019 | COLCOT: Colchicine and the Return of the Anti-Inflammatory Theory

Low-dose colchicine seems to reduce the risk for new cardiovascular events in patients with a history of infarction.

This drug is usually indicated for anti-inflammatory therapy in gout and pericarditis. Now, it could also reduce the rate of ischemic events as secondary prevention according to the COLCOT trial presented during the American Heart Association (AHA) Congress Scientific Sessions and simultaneously published in NEJM. COLCOT reinforces the evidence on the role of anti-inflammatory therapy in atherosclerosis and its complications, allowing for the potential inclusion of colchicine in the drug cocktail administered after an acute myocardial infarction.

COLCOT randomized 4745 patients (mean age 60.6 years old; 19.2% women) in 12 countries to low-dose colchicine (0.5 mg once a day) vs. placebo. Patients enrolled at a mean of 13.5 days after infarction, and 93% underwent angioplasty.

The primary endpoint was a composite of death from cardiovascular causes, resuscitated cardiac arrest, infarction, stroke, and rehospitalization for angina requiring revascularization.


Read also: AHA 2019 | ISCHEMIA: The Invasive Approach (PCI or Surgery) Results Similar to Optimal Medical Treatment.


After almost two years of follow-up, patients who received colchicine experienced significantly less events than those who received placebo (5.5% vs 7.1%; hazard ratio [HR]: 0.77; 95% confidence interval [CI]: 0.61-0.96).

The reduction in the combined endpoint was driven by lower rates of stroke (HR: 0.26; 95% CI: 0.10-0.70) and lower rates of emergency revascularization (HR: 0.50; 95% CI: 0.31-0.81). All other endpoint components, including death and infarction, were similar.

What comes next is the COLCOT-T2D trial, which aims to enroll 10,000 type 2 diabetes patients without a history of coronary disease.

colcot-aha2019

Original Title: Efficacy and safety of low-dose colchicine after myocardial infarction.

Reference: Tardif J-C. Presentado en el congreso de la AHA 2019 y publicado simultáneamente en N Engl J Med. 2019; Epub ahead of print.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

STEACS and the Use of Bivalirudin vs. Heparin: In Search of BRIGHT-4 Outcomes

Various studies and registries have previously shown the impact of post-percutaneous coronary intervention (PCI) complications on the survival of patients with ST-segment elevation acute...

TAVR and Atrial Fibrillation: What Anticoagulants Should We Use?

The prevalence of atrial fibrillation (AF) in TAVR patients ranges from 15 to 30%, depending on series. This arrhythmia has been associated to higher...

Ultrathin vs Thin-Strut Stents in PCI Patients at High Bleeding Risk

Several in vivo studies have shown that ultrathin stents present lower thrombogenic risk vs. thin-strut stents, which reflects in lower rates of target lesion...

Should We Withdraw Anticoagulation Before TAVR?

Approximately one-third of patients undergoing transcatheter aortic valve replacement (TAVR) have atrial fibrillation and are on oral anticoagulant (OAC) therapy. This creates a complex...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....