COLCOT: Colchicine Reduces Ischemic Event Risk after Recent MI

The daily use of colchicine significantly reduces the risk of first and total ischemic cardiovascular (CV) events compared to placebo in patients with a recent myocardial infarction (MI), according to newly presented findings from the American Heart Association 2019 Scientific Sessions in Philadelphia.

Researchers enrolled 4,745 participants from 167 sites. The study participants were required to have suffered a heart attack within the last 30 days and have completed any planned percutaneous revascularization procedures. Subjects were randomized (1:1) to receive either 0.5 mg/daily of colchicine or a placebo and were followed until the occurrence of at least 301 CV events. Follow-up visits occurred at one and three months following randomization, and every three months thereafter. Patients also received standard medical care including intensive use of statins. The primary study endpoint was the time from randomization to the first event of CV mortality, resuscitated cardiac arrest, non-fatal MI, non-fatal stroke, or urgent hospitalization for angina requiring coronary revascularization.

The results indicated that patients treated with colchicine experienced a 23% lower rate of the composite primary endpoint juxtaposed with patients taking placebo. Moreover, the reduction in risk of the primary endpoint with colchicine was augmented by 28% in patients who adhered to the testing protocol while undergoing at least six months of treatment, with event rates of 5.0% and 6.9% for colchicine and placebo, respectively. Risk reduction for the primary endpoint was achieved in 35% of patients receiving therapy, with event rates of 4% in the colchicine group and 6.1% in the placebo group, respectively. Overall, rate of total primary endpoint events was reduced by 34% with colchicine compared with placebo therapy.

“The COLCOT results apply to patients who have recently suffered a myocardial infarction,” researcher Jean-Claude Tardif, MD, of Montreal Heart Institute said in a presentation. “Further research is needed to assess the benefits of colchicine in other high-risk patients.”