Key result
Colchicine use after a first acute myocardial infarction significantly reduced the risk of all-cause death compared to non-users (HR 0.560; 95% CI 0.361-0.862; P=0.008).
Why the study?
Although evidence demonstrates the protective anti-inflammatory benefits of colchicine in acute myocardial infarction, investigations in Asian populations are limited.
Does colchicine reduce mortality and cardiovascular events in patients with a recent first acute myocardial infarction?
Cohort (n=2,841)
No
Does colchicine reduce mortality and cardiovascular events in patients with a recent first acute myocardial infarction?
Hazard Ratio: 0.56 (95% CI 0.361–0.862)
p-value: p=0.008
Early initiation of low-dose colchicine after a first acute myocardial infarction is associated with a significantly lower risk of all-cause and cardiovascular death in an Asian real-world cohort.
Colchicine use was associated with lower CV death risk after AMI in Asians; extends prior data but leaves open need for RCTs before practice change.
BACKGROUND: Clinical and experimental evidence have demonstrated the protective benefits of colchicine in acute myocardial infarction (AMI) through its potential anti-inflammatory effect. However, investigations on the Asian population are limited. METHODS: This retrospective longitudinal cohort study used electronic medical records from a tertiary medical center in Taiwan. Patients with their first AMI from the emergency department between 2010 and 2020 were included. The outcomes included all-cause death, hospitalization for heart failure, stroke, and emergency admission for angina. Propensity-score matching (PSM, 5 to 1) and Cox's proportional hazards regression model were used to estimate hazard ratios (HRs). RESULTS: A total of 2841 patients with their first admission for AMI were identified, of which 176 (6.2%) received colchicine and 2665 (93.8%) did not. After a median follow-up of 21.4 months, the incidence of all-cause death was significantly reduced in the colchicine group (HR, 0.560; 95% confidence interval [CI], 0.361-0.862; P = 0.008), driven by the significant risk reduction of cardiovascular death (HR, 0.291; 95% CI, 0.142-0.613; P = 0.001). There was no significant difference of other outcomes. After PSM, the protective effect remained in the colchicine group compared with non-users (HR, 0.331; 95% CI, 0.162-0.690; P = 0.003). The relationship between endpoints and various time-to-treatment initiation showed a significant reduction in the risk of all-cause death for whom colchicine was initiated < Day 3 compared with placebo. CONCLUSION: Low-dose colchicine led to a significantly lower risk of cardiovascular death than non-users among patients with a recent myocardial infarction. They benefit from early, in-hospital initiation of colchicine after AMI.
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Chang et al. (2024) conducted a cohort in acute myocardial infarction (n=2,841). Colchicine vs. non-users was evaluated on all-cause death (HR 0.560, 95% CI 0.361-0.862, p=0.008). Colchicine use after a first acute myocardial infarction significantly reduced the risk of all-cause death compared to non-users (HR 0.560; 95% CI 0.361-0.862; P=0.008).
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