Effect of colchicine after primary acute coronary syndrome in heart failure with preserved ejection fraction
R V Shamoyan, A L Chilingaryan, L G Tunyan, H G Hayrapetyan, V G HakobjanyanAbstract
Background
Colchicine is an anti-inflammatory medication, classically used to treat a wide spectrum of autoimmune diseases. Atherosclerosis is a chronic inflammatory vascular disease, and the inflammatory process is involved in all stages of its progression, from early plaque formation to instability and disruption, leading to clinical events. Consequently, atherosclerotic cardiovascular disease(ASCVD) requires anti-inflammatory pharmacotherapy.
Purpose
The objective of this study was to evaluate the role of colchicine in patients discharged after primary acute coronary syndrome(pACS) with heart failure with preserved ejection fraction(HFpEF).
Methods
We enrolled 68 patients(37 males and 31 females, mean age 59±6 years) presenting with primary acute coronary syndrome(pACS) complicated by heart failure with preserved ejection fraction(HFpEF) and elevated inflammatory markers, specifically C-reactive protein(CRP) and Interleukin-6(IL-6). All patients received guideline-directed medical therapy(GDMT). The cohort was divided into two groups: 34 patients who were prescribed colchicine(C group) and 34 patients who were not (non-C group).
Results
C group of patients was prescribed 0.5 mg colchicine at discharge in addition to GDMT. 47 patients performed PCI(26 males and 21 females). The study's endpoint was rehospitalisation and mortality at a 6-month follow-up. In the C group, approximately 45% lower CRP and 42% lower IL-6 levels were observed than in the non-C group at 6 months. The results have shown that in the C group there was twice lower cardiovascular rehospitalisation and mortality than in the non-C group(see table 1), p<0.04.
Conclusion
Low-dose colchicine is recognized as a potent anti-inflammatory agent for secondary prevention in patients with ASCVD, including those following a pACS event with HFpEF.For image description, please refer to the figure legend and surrounding text.