Key result
Colchicine significantly reduced the risk of major adverse cardiovascular events (RR 0.56) compared to control in patients with recent acute myocardial infarction.
Why the study?
Current evidence on the efficacy and safety of colchicine after acute myocardial infarction remains controversial.
Does colchicine reduce major adverse cardiovascular events in patients with acute myocardial infarction?
Meta-Analysis (n=5,872)
Does colchicine reduce major adverse cardiovascular events in patients with acute myocardial infarction?
Relative Risk: 0.56 (95% CI 0.48–0.67)
p-value: p=<0.00001
Early, long-term, low-dose colchicine (0.5 mg/d) significantly reduces the risk of MACE in patients with recent AMI without increasing gastrointestinal adverse events.
Supports low-dose long-term colchicine to lower MACE post-AMI; extends RCT evidence by clarifying dose- and duration-dependent efficacy with GI trade-offs.
Background: Current evidence on the efficacy and safety of colchicine after acute myocardial infarction (AMI) remains controversial. This study aims to clarify early low-dose long-term colchicine's exact efficacy and safety in AMI patients via more studies. Methods: We searched PubMed, Web of Science, Embase, and Cochrane Library databases for randomized controlled trials assessing the efficacy of colchicine on major adverse cardiovascular events (MACE) in recent AMI patients from inception to January 29, 2023, without any restriction. Additionally, we conducted subgroup analyses to assess the impact of early (≤3 days) long-term (≥1 year) low-dosage (0.5 mg/d) colchicine. Summary estimates were computed using Mantel-Haenszel and reported as risk ratios (RRs) or standard mean differences (SMDs), mean differences (MDs) with 95% confidence intervals (CIs). Sensitivity analyses were performed to explore the potential sources of heterogeneity. Review Manager software was used for the meta-analysis. Results: Eight studies identified from 564 screened records were analyzed, with 5,872 patients after AMI. The length of follow-up varied from five days to 22.7 months, and 0.5-1.0 mg colchicine was administered daily. In summary, compared to the control group, colchicine reduced the occurrence of MACE (RR, 0.56; 95% CI, 0.48-0.67) with 2.99-fold gastrointestinal adverse events in patients with recent AMI. Moreover, the relation referred to a gradual decrease in the occurrence of MACE with a longer follow-up duration (≥1 year) and lower dosage (0.5 mg/d) without leading more gastrointestinal adverse events. Colchicine decreased the follow-up levels of C-reactive protein (CRP) (MD -0.66, 95% CI, -0.98- -0.35) and neutrophils (SMD -0.22, 95% CI, -0.39- -0.55) when the follow-up period was 30 days. Conclusion: Early long-term low-dose colchicine decreases the risk of MACE via anti-inflammation without leading more gastrointestinal adverse events in patients with AMI.
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Zhou et al. (2023) conducted a meta-analysis in Acute myocardial infarction (AMI) (n=5,872). Colchicine vs. Standard treatment or placebo was evaluated on Major adverse cardiovascular events (MACE) (RR 0.56, 95% CI 0.48-0.67, p=<0.00001). Colchicine significantly reduced the risk of major adverse cardiovascular events (RR 0.56) compared to control in patients with recent acute myocardial infarction.
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