March 26, 2026Open Access

The Effect of Colchicine on Pericoronary Adipose Tissue Attenuation by Serial Coronary Ct Angiography: A Substudy of the Ekstrom Trial

Key Result

Colchicine (0.5 mg/day) did not significantly alter pericoronary adipose tissue attenuation over 12 months versus placebo in stable CAD patients (between-group change 0.3 HU, p=0.857).

Key Points

This research investigates the impact of colchicine on pericoronary adipose tissue attenuation in patients with stable coronary artery disease.
Post-hoc analysis of the EKSTROM trial, a prospective, placebo-controlled study.
Patients with stable CAD were randomized to receive colchicine (0.5 mg/day) or placebo.
Changes in pericoronary adipose tissue attenuation were measured using serial coronary CT angiography over 12 months.
Multivariable linear regression models adjusted for risk factors and baseline PCAT attenuation were utilized.
In the colchicine group, mean PCAT attenuation increased slightly from -73.6 HU to -73.1 HU.
In the placebo group, mean PCAT attenuation also increased slightly from -75.3 HU to -74.5 HU.
No significant difference in the change of mean PCAT attenuation was observed between treatment groups (p=0.857).
Multivariate analysis showed no significant association between colchicine and changes in PCAT over 12 months.

Structured PICO

Does colchicine 0.5 mg/day improve pericoronary adipose tissue attenuation in patients with stable coronary artery disease?

Population

71 participants with stable coronary artery disease (CAD), mean age 64.6 ±7.3, 12% female, mean hsCRP 0.8 mg/L.

Intervention

Colchicine 0.5 mg/day for 12 months

Comparator

Placebo for 12 months

Outcome

Change in mean pericoronary adipose tissue (PCAT) attenuation between treatment groups at 12 monthssurrogate

Low-dose colchicine (0.5 mg/day) did not significantly alter pericoronary adipose tissue attenuation, an imaging biomarker of coronary inflammation, over 12 months in patients with stable CAD.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Inflammation plays a pivotal role in initiation and progression of coronary artery disease (CAD). Pericoronary adipose tissue (PCAT) attenuation on coronary CT angiography (CCTA) is a novel non-invasive biomarker of coronary inflammation. Low dose colchicine has been shown to safely lower cardiovascular events among patients with stable CAD. We sought to investigate whether colchicine is associated with changes in PCAT by serial CCTA in patients enrolled in the Effect of Colchicine on Progression of Known Coronary Atherosclerosis in Patients with STable CoROnary Artery Disease CoMpared to Placebo (EKSTROM) trial. This is a post-hoc analysis of the EKSTROM trial, a prospective, placebo-controlled serial CCTA trial that randomized patients with stable CAD to receive either colchicine (0.5 mg/day) or placebo, and followed for 12 months. PCAT attenuation was quantified using partially-automated Medis QAngioCT software. Multivariable linear regression models were adjusted for traditional cardiovascular risk factors and baseline PCAT attenuation to examine the change in mean PCAT attenuation between the treatment groups. The analysis included 71 participants (12% female, mean age 64.6 ±7.3, mean hsCRP 0.8 mg/L). Mean PCAT attenuation in the colchicine group was -73.6 HU ±8.0 at baseline which increased to -73.1 HU ±8.2 at 12-month follow-up. Mean PCAT attenuation in the placebo group was -75.3 HU ±7.4 at baseline, which increased to 74.5 HU ±6.8 at follow-up, with a between group change of 0.3 HU ±8.0 (p=0.857). Multivariate regression analysis showed no significant change in mean PCAT attenuation between groups. Colchicine was not associated with a significant change in PCAT over 12 months in participants in the EKSTROM trial with stable CAD. Larger studies with long-term follow up are needed to evaluate the mechanistic benefits of colchicine on the complex interactions of coronary atherosclerosis, inflammation, and adverse CV risk.