Colchicine use in CAD and HFpEF was associated with a lower 1-year risk of composite CV events and mortality compared to non-users (16.9% vs 19.8%; HR 0.86; 95% CI 0.81-0.91; p<0.001).
Cohort (n=57,882)
Yes
Does colchicine reduce the composite of acute myocardial infarction, stroke, all-cause mortality, and acute heart failure in adults with CAD and HFpEF?
Colchicine use in patients with CAD and HFpEF is associated with a lower short- and medium-term risk of composite cardiovascular events and mortality.
Effect estimate: HR 0.86 (95% CI 0.81-0.91)
Absolute Event Rate: 16.9% vs 19.8%
p-value: p=<0.001
Background: Coronary artery disease (CAD) and heart failure with preserved ejection fraction (HFpEF) are major causes of morbidity and mortality. Systemic inflammation contributes to both, suggesting potential benefit from colchicine, though data in CAD-HFpEF are limited. Methods: We conducted a real-world study using the TriNetX Research Network, identifying 480,434 adults with CAD and HFpEF. Patients were categorized as colchicine users (n = 30,254) or non-users (n = 450,180). One-to-one propensity score matching yielded 28,941 patients per group. The primary outcome was a composite of acute myocardial infarction, stroke, all-cause mortality, and acute heart failure. Secondary outcomes included individual components, hospitalizations, atrial fibrillation, and gastrointestinal events, assessed at 1- and 3-year follow-up. Results: At 1 year, the primary outcome occurred in 16.9% of the colchicine group versus 19.8% of non-users (HR: 0.86, 95% CI: 0.81–0.91; p < 0.001). All-cause mortality was 11.4% versus 14.5% (HR: 0.77, 95% CI: 0.73–0.80; p < 0.001). At 3 years, the primary outcome occurred in 34.2% versus 39.7% (HR: 0.88, 95% CI: 0.85–0.92; p < 0.001), with acute heart failure slightly higher in the colchicine group (27.5% vs. 26.5%; HR: 1.04, 95% CI: 1.01–1.08; p = 0.009). Stroke was modestly reduced (HR: 0.93, 95% CI: 0.88–0.99; p = 0.014). No significant differences were seen in all-cause hospitalization, atrial fibrillation, or gastrointestinal events. Conclusions: In patients with CAD and HFpEF, colchicine was associated with lower short- and medium-term risk of composite cardiovascular events and mortality, with modest attenuation over time, suggesting early time-dependent association rather than sustained structural effects. Prospective randomized trials are warranted.
Ahmed et al. (Sat,) conducted a cohort in Coronary artery disease and heart failure with preserved ejection fraction (n=57,882). Colchicine vs. Non-users was evaluated on Composite of acute myocardial infarction, stroke, all-cause mortality, and acute heart failure (HR 0.86, 95% CI 0.81-0.91, p=<0.001). Colchicine use in CAD and HFpEF was associated with a lower 1-year risk of composite CV events and mortality compared to non-users (16.9% vs 19.8%; HR 0.86; 95% CI 0.81-0.91; p<0.001).