Physicians' Academy for Cardiovascular Education

Consistent CV benefit of colchicine in patients with coronary disease

Efficacy and safety of low-dose colchicine in patients with coronary disease: a systematic review and meta-analysis of randomized trials

Literature - Fiolet ATL, Opstal TSJ, Mosterd A et al., - Eur Heart J 2021, doi:10.1093/eurheartj/ehab115

Introduction and methods

Recent trials demonstrated that use of colchicine resulted in reduction of major adverse cardiovascular events (MACE) in patient with coronary disease [1,2]. Potential mechanisms of benefit observed with colchicine include inhibition of inflammasome activation; inhibition of neutrophil chemotaxis, adhesion and activation; and inhibition of neutrophil-platelet interaction [3-5].

A systematic review and meta-analysis of randomized trials was performed to assess the overall effect of colchicine on MACE and individual end points in patients with acute or chronic coronary disease.

Eligible studies compared the efficacy of long-term colchicine treatment (≥3 months) with standard treatment with or without placebo in a patient population with established atherosclerosis. The pre-specified primary endpoint of this meta-analysis was the composite of MI, stroke, or CV death. 5 Trials were included, involving 11,816 patients randomized to colchicine (n=5918) or placebo or standard treatment (n=5898). 46.9% Of patients were enrolled within 30 days of acute coronary syndrome and 51.3% of patients had chronic coronary disease.

Main results


This meta-analysis of 5 trials evaluating the effect of low-dose colchicine showed that colchicine reduced MACE and individual CV endpoints compared to placebo or no colchicine in patients with acute and chronic coronary disease when added to contemporary treatment.


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Find this article online at Eur Heart J

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