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04-04-2024 | Colchicine | Global Cardiovascular Health (L Sperling and D Gaita, Section Editors)

Colchicine for the Prevention of Cardiovascular Disease: Potential Global Implementation

Authors: Robert S. Zhang, Brittany N Weber, Diego Araiza-Garaygordobil, Michael S. Garshick

Published in: Current Cardiology Reports

Abstract

Purpose of Review

Targeting traditional cardiovascular risk factors is effective in reducing recurrent cardiovascular events, yet the presence of residual cardiovascular risk due to underlying systemic inflammation is a largely unaddressed opportunity. This review aims to comprehensively assess the evolving role of colchicine as a therapeutic approach targeting residual inflammatory risk in the context of those with coronary artery disease (CAD).

Recent Findings

Inflammation plays a significant role in promoting atherosclerosis, and targeting anti-inflammatory pathways has the potential to decrease cardiovascular events. Low-dose colchicine (0.5 mg/day orally), when added to guideline-directed medical care for CAD, safely decreases major adverse cardiovascular events (MACE) by 31% in stable atherosclerosis patients and 23% in those after recent myocardial infarctions. Meta-analyses of recent randomized control trials further support both the efficacy and safety of colchicine, particularly when added to other standard cardiovascular therapies, including statin therapy. The European Society of Cardiology and other national guidelines endorse the use of low-dose colchicine in patients across the spectrum of CAD. Recently, colchicine was FDA-approved in the United States as the first anti-inflammatory therapy for the reduction of cardiovascular events. In a period of a rising incidence of CAD across the globe, colchicine represents a unique opportunity to decrease MACE due to its large magnitude of benefits and general affordability. However, challenges with drug interactions must be addressed, especially in those regions where HIV, hepatitis, and tuberculosis are prevalent.

Summary

Colchicine is safe and effective at reducing cardiovascular events across a broad spectrum of coronary syndromes. The ability to simultaneously target traditional risk factors and mitigate residual inflammatory risk marks a substantial advancement in cardiovascular prevention strategies, heralding a new era in the global battle against CAD.

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Title: Colchicine for the Prevention of Cardiovascular Disease: Potential Global Implementation
Authors: Robert S. Zhang
Brittany N Weber
Diego Araiza-Garaygordobil
Michael S. Garshick
Publication date: 04-04-2024
Publisher: Springer US
Keywords: Colchicine
Arterial Diseases
Arterial Occlusive Disease
Published in: Current Cardiology Reports
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI: https://doi.org/10.1007/s11886-024-02049-y

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Colchicine for the Prevention of Cardiovascular Disease: Potential Global Implementation

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ACC 2024 Congress Coverage

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Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page