Colchicine in Patients With Chronic Coronary Disease in Relation to Prior Acute Coronary Syndrome

被引：45

作者：

Opstal, Tjerk S. J. ^{[1
,2
]}

Fiolet, Aernoud T. L. ^{[3
,4
]}

van Broekhoven, Amber ^{[1
]}

Mosterd, Arend ^{[4
,5
]}

Eikelboom, John W. ^{[6
]}

Nidorf, Stefan M. ^{[7
,8
]}

Thompson, Peter L. ^{[7
,9
,10
]}

Duyvendak, Michiel ^{[11
,12
]}

van Eck, J. W. Martijn ^{[13
]}

van Beek, Eugene A. ^{[14
]}

den Hartog, Frank ^{[15
]}

Budgeon, Charley A. ^{[10
]}

Bax, Willem A. ^{[16
]}

Tijssen, Jan G. P. ^{[17
,18
]}

El Messaoudi, Saloua ^{[1
]}

Cornel, Jan H. ^{[1
,2
]}

机构：

[1] Radboud Univ Nijmegen, Med Ctr, Dept Cardiol, Nijmegen, Netherlands

[2] Northwest Clin, Dept Cardiol, Alkmaar, Netherlands

[3] Univ Med Ctr Utrecht, Dept Cardiol, Utrecht, Netherlands

[4] Dutch Network Cardiovasc Res, Utrecht, Netherlands

[5] Meander Med Ctr, Dept Cardiol, Amersfoort, Netherlands

[6] McMaster Univ, Dept Med, Hamilton, ON, Canada

[7] Sir Charles Gairdner Hosp, Heart & Vasc Res Inst Western Australia, Perth, WA, Australia

[8] GenesisCare Western Australia, Perth, Australia

[9] Harry Perkins Inst Med Res, Perth, WA, Australia

[10] Univ Western Australia, Perth, WA, Australia

[11] Antonius Hosp Sneek, Dept Clin Pharm, Sneek, Netherlands

[12] Pharm Res, Sneek, Netherlands

[13] Jeroen Bosch Hosp, Dept Cardiol, sHertogenbosch, Netherlands

[14] St Jansdal Hosp, Dept Cardiol, Harderwijk, Netherlands

[15] Gelderse Vallei Hosp, Dept Cardiol, Ede, Netherlands

[16] Northwest Clin, Dept Internal Med, Alkmaar, Netherlands

[17] Univ Amsterdam, Med Ctr, Dept Cardiol, Amsterdam, Netherlands

[18] Cardialysis BV, Rotterdam, Netherlands

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2021年 / 78卷 / 09期

基金：

英国医学研究理事会;

关键词：

atherosclerosis; cardiovascular inflammation; ischemic risk; myocardial infarction; secondary prevention; anti-inflammatory agents; ACUTE MYOCARDIAL-INFARCTION; TICAGRELOR; TIME;

D O I：

10.1016/j.jacc.2021.06.037

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Colchicine reduces risk of cardiovascular events in patients post-myocardial infarction and in patients with chronic coronary disease. It remains unclear whether this effect is related to the time of onset of treatment following an acute coronary syndrome (ACS). OBJECTIVES This study investigates risk for major adverse cardiovascular events in relation to history and timing of prior ACS, to determine whether the benefits of colchicine are consistent independent of prior ACS status. METHODS The LoDoCo2 (Low-Dose Colchicine 2) trial randomly allocated patients with chronic coronary disease to colchicine 0.5 mg once daily or placebo. The rate of the composite of cardiovascular death, spontaneous myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization was compared between patients with no prior, recent (6-24 months), remote (2-7 years), or very remote (>7 years) ACS; interaction between ACS status and colchicine treatment effect was assessed. RESULTS In 5,522 randomized patients, risk of the primary endpoint was independent of prior ACS status. Colchicine consistently reduced the primary endpoint in patients with no prior ACS (incidence: 2.8 vs 3.4 events per 100 person-years; hazard ratio [HR]: 0.81; 95% confidence interval [CI]: 0.52-1.27), recent ACS (incidence: 2.4 vs 3.3 events per 100 person-years; HR: 0.75; 95% CI: 0.51-1.10), remote ACS (incidence: 1.8 vs 3.2 events per 100 person-years, HR: 0.55; 95% CI: 0.37-0.82), and very remote ACS (incidence: 3.0 vs 4.3 events per 100 person-years, HR: 0.70; 95% CI: 0.51-0.96) (P for interaction 1/4 0.59). CONCLUSIONS The benefits of colchicine are consistent irrespective of history and timing of prior ACS. (The LoDoCo2 Trial: Low Dose Colchicine for secondary prevention of cardiovascular disease [LoDoCo2] ACTRN12614000093684). (C) 2021 by the American College of Cardiology Foundation.

引用

页码：859 / 866

页数：8

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