COLIN trial: Value of colchicine in the treatment of patients with acute myocardial infarction and inflammatory response

Arch Cardiovasc Dis. 2017 Jun-Jul;110(6-7):395-402. doi: 10.1016/j.acvd.2016.10.004. Epub 2017 Jan 3.

Abstract

Background: Inflammation is involved during acute myocardial infarction, and could be an interesting target to prevent ischaemia-reperfusion injuries. Colchicine, known for its pleiotropic anti-inflammatory effects, could decrease systemic inflammation in this context.

Aims: To evaluate the impact of colchicine on inflammation in patients admitted for ST-segment elevation myocardial infarction (STEMI).

Methods: All patients admitted for STEMI with one of the main coronary arteries occluded, and successfully treated with percutaneous coronary intervention, were included consecutively. Patients were randomized to receive either 1mg colchicine once daily for 1 month plus optimal medical treatment or optimal medical treatment only. C-reactive protein (CRP) was assessed at admission and daily until hospital discharge. The primary endpoint was CRP peak value during the index hospitalization.

Results: Forty-four patients were included: 23 were treated with colchicine; 21 received conventional treatment only. At baseline, both groups were well balanced regarding age, sex, risk factors, thrombolysis in myocardial infarction flow and reperfusion delay. The culprit artery was more often the left anterior descending artery in the colchicine group (P=0.07), reflecting a more severe group. There was no significant difference in mean CRP peak value between the colchicine and control groups (29.03mg/L vs 21.86mg/L, respectively; P=0.36), even after adjustment for type of culprit artery (26.99 vs 24.99mg/L, respectively; P=0.79).

Conclusion: In our study, the effect of colchicine on inflammation in the context of STEMI could not be demonstrated. Further larger studies may clarify the impact of colchicine in acute myocardial infarction.

Keywords: Acute coronary syndrome; Cardiovascular disease; Colchicine; Heart failure; Infarctus du myocarde; Insuffisance cardiaque; Myocardial infarction; Pathologies cardiovasculaires; Syndrome coronarien aigu.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Colchicine / adverse effects
  • Colchicine / therapeutic use*
  • Coronary Occlusion / blood
  • Coronary Occlusion / diagnostic imaging
  • Coronary Occlusion / therapy*
  • Echocardiography
  • Female
  • France
  • Humans
  • Inflammation / blood
  • Inflammation / diagnosis
  • Inflammation / drug therapy*
  • Inflammation Mediators / blood*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention*
  • Prospective Studies
  • ST Elevation Myocardial Infarction / blood
  • ST Elevation Myocardial Infarction / diagnostic imaging
  • ST Elevation Myocardial Infarction / therapy*
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Biomarkers
  • Inflammation Mediators
  • C-Reactive Protein
  • Colchicine