Abstract
Objective: The anti-inflammatory drug Colchicine has recently shown benefits in the prevention of major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) and chronic coronary syndromes (CCS). This meta-analysis focuses on understanding Colchicine's effects on the high sensitivity C-reactive protein (hs-CRP) to provide mechanistic insight to explain its clinical event reduction.
Methods: A computerized search of MEDLINE was conducted to retrieve journal articles with studies performed on humans from January 1, 2005, to January 1, 2022, using keywords: “Colchicine AND Coronary”, “Colchicine AND CRP”, and “Colchicine AND 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 CCS.
Results: Thirteen studies with a biomarker subgroup population of 1636 patients were included in the hs-CRP meta-analysis. Of those 13 studies, 8 studies with a total population of 6016 reported clinical events defined as myocardial infarction (MI), stroke, cardiovascular death, periprocedural MI, repeat angina after PCI, and repeat revascularization. . A multivariate analysis revealed a weak negative correlation of -0.1056 (p= 0.805) between change in CRP and clinical events. Overall, colchicine treatment resulted in greater reduction in hs-CRP levels compared with placebo (standardized mean difference [MD-1.59 [95% CI: -2.40, -0.79], p=0.0001) and clinical events (Odds Ratio: 0.78 [0.64, 0.95], p=0.01).
Conclusion: Colchicine therapy is associated with a reduction in hs-CRP and clinical events in patients with ACS and CCS. This finding supports colchicine’s anti-inflammatory efficacy via CRP reduction to explain its clinical benefit.
Methods: A computerized search of MEDLINE was conducted to retrieve journal articles with studies performed on humans from January 1, 2005, to January 1, 2022, using keywords: “Colchicine AND Coronary”, “Colchicine AND CRP”, and “Colchicine AND 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 CCS.
Results: Thirteen studies with a biomarker subgroup population of 1636 patients were included in the hs-CRP meta-analysis. Of those 13 studies, 8 studies with a total population of 6016 reported clinical events defined as myocardial infarction (MI), stroke, cardiovascular death, periprocedural MI, repeat angina after PCI, and repeat revascularization. . A multivariate analysis revealed a weak negative correlation of -0.1056 (p= 0.805) between change in CRP and clinical events. Overall, colchicine treatment resulted in greater reduction in hs-CRP levels compared with placebo (standardized mean difference [MD-1.59 [95% CI: -2.40, -0.79], p=0.0001) and clinical events (Odds Ratio: 0.78 [0.64, 0.95], p=0.01).
Conclusion: Colchicine therapy is associated with a reduction in hs-CRP and clinical events in patients with ACS and CCS. This finding supports colchicine’s anti-inflammatory efficacy via CRP reduction to explain its clinical benefit.
| Original language | English |
|---|---|
| Journal | Coronary Artery Disease |
| Publication status | Accepted/In press - 24 Nov 2022 |
Keywords
- Colchicine
- C-reactive Protein
- CRP
- hs-CRP
- Acute Coronary Syndrome
- Coronary Artery Disease
