Colchicine in Coronary Artery Disease—Too Much of a Good Thing?

Coronary artery disease (CAD) is the leading cause of mortality and morbidity in the world. While low-density lipoprotein cholesterol has been the main target of secondary prevention, inflammation has gained traction as a potential target for reducing adverse cardiovascular events. Hence, in this review, we aim to outline the current evidence base for the use of colchicine in CAD to provide more clarity from the findings in the recent trials and meta-analyses (LoDoCo2, COLCOT, COPS, CONVINCE, CLEAR-SYNERGY, COLOCT, and EKSTROM). Given colchicine’s low cost and widespread availability, it is a potential adjunct to lipid-lowering therapy. However, it may not be as effective in the secondary prevention of CAD as previously thought. Ongoing research on colchicine remains vital to determine its utility in patient populations beyond those with CAD as well as to better understand the fine balance between its therapeutic benefits and potential side effects.