The effect of early administration of colchicine in non ST-segment-elevation myocardial infarction patients.

In re-perfused non ST-segment-elevation myocardial infarction, inflammation is a major contributor to myocardial damage. One of these medicines is colchicine, a well-known medication that has been used in clinical practice for millennia to treat inflammation. Indeed, colchicine has direct anti-inflammatory and pleiotropic effects, as well as possible anti-arrhythmic, anti-fibrotic and anti-atherosclerotic properties all of which are very relevant in this population. Colchicine effects in the context of acute myocardial infarction were investigated in numerous clinical studies.

We hypothesized that early administration of the potent anti-inflammatory medication called colchicine could improve outcomes with non-ST-segment-elevation myocardial infarction. Our primary goal was to compare the primary effectiveness and safety endpoints

We conducted a randomized, double-blind trial with patients enrolled within 1 day to 30 days following a myocardial infarction. One group receives 2 mg colchicine on the first day of MI before PCI, while the second group receives colchicine after PCI for 30 days after myocardial infarction. The initial dose was 2 mg, which was followed by 0.5 mg of colchicine once a day for one month. The primary effectiveness endpoint was a composite of cardiovascular-related death, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina requiring coronary revascularization. All-cause mortality, Acute renal damage, bleeding, gastrointestinal events and life-threatening arrhythmias were used to determine safety. The components of the primary endpoint and safety, HS-CRP,6 min walk, EF were also evaluated on a day 0, 1 and 3 month follow up visits from randomization.

A total of 172 patients satisfied the inclusion criteria and were randomized. One hundred patients were assigned to the early treatment group, and 72 to the late treatment group. Colchicine pre-treatment in NSTMI patients (Group 1) reduces the risk of cardiovascular-related death, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina requiring coronary revascularization, as well as the composite of adverse cardiovascular events, Hs-CRP levels( P < 0.05). . The risk of adverse gastrointestinal events were increased in both group, there was no significant difference between them ( P < 0.05). . Also there was no significant difference between groups in on all-cause mortality, or the incidence of stroke (P < 0.05). .

Early administration of Colchicine lowers the risk of cardiovascular-related death, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina requiring coronary revascularization (P < 0.05). Early administration no influence on the incidence of stroke, or all-cause death.