Colchicine in PCI Linked with Reduced Inflammation

The use of colchicine can reduce inflammation during percutaneous coronary intervention (PCI), according to the findings of a new study presented at the American Heart Association 2019 Scientific Sessions in Philadelphia.

The researchers noted that vascular injury and inflammation during PCI results in rapid neutrophil recruitment to the trauma site and is correlated with endothelial cell and microvascular dysfunction. Injury and inflammation are independent predictors of subsequent major adverse cardiovascular events (MACE), even in the contemporary era with assess to second-generation drug-eluting stents (DES).

To conduct this double-blind trial, researchers assessed 400 study subjects who underwent PCI and were randomized to receive colchicine or a placebo. The sample size of 400 provided the researchers with an 80% power to detect a 40% reduction in the primary endpoint, which was defined as peri-procedural myocardial injury within 24 hours post-PCI. The study’s secondary endpoint was specified as the composite of non-fatal myocardial infarction, target vessel revascularization, and all-cause mortality at 30 days.

According to the results of the study, compared with placebo, short-term pre-procedural colchicine did not reduce PCI-related myocardial injury or MACE at 30 days. However, colchicine did attenuate PCI-related increase in both IL-6 and hsCRP concentration at 24 hours post-PCI, indicating that the therapy effectively mitigated the increase in inflammation after PCI when compared with placebo.

“This is the first study to demonstrate that an oral load of colchicine prevents a rise of inflammatory biomarkers in acute injury,” lead researcher Binita Shah, MD, of New York University (NYU) School of Medicine, noted in a presentation.

On study limitations, Dr. Shah said: “Genetic data were not collected in the current trial to determine predisposition to colchicine resistance.”