Key result
Colchicine cuts MACE ~26% vs. placebo in acute coronary syndrome.
Why the study?
ACS remains a major contributor to mortality and long-term cardiovascular risk despite optimal treatment, and this study evaluated the safety and impact of the anti-inflammatory agent colchicine on MACE, hsCRP levels, and cardiac function in ACS patients.
Does colchicine reduce major adverse cardiovascular events in patients with acute coronary syndrome?
Meta-Analysis (n=14,688)
Randomized controlled trials
Yes
Does colchicine reduce major adverse cardiovascular events in patients with acute coronary syndrome?
In a meta-analysis of 18 RCTs, colchicine significantly reduced major adverse cardiovascular events, lowered hsCRP levels, and slightly improved LVEF in patients with acute coronary syndrome, at the cost of increased diarrhea.
Supports colchicine for MACE prevention in high-risk patients; confirms benefit in meta-analysis of randomized trials.
Background: Acute coronary syndrome (ACS) remains a major contributor to global mortality and long-term cardiovascular risk despite optimal treatment. Colchicine, an anti-inflammatory agent, has gained attention for its potential benefits in ACS. This meta-analysis evaluates its safety and impact on major adverse cardiovascular events (MACE), high-sensitivity C-reactive protein (hsCRP) levels, and cardiac function in ACS patients. Methods: We performed a systematic literature search of randomized controlled trials on PubMed (MEDLINE), Embase, and Scopus databases from inception to January 1st, 2025. We pooled dichotomous outcomes as risk ratios (RR) and continuous outcomes as mean differences (MD) with 95% confidence intervals, using random-effects models. Heterogeneity was assessed using I2 and X2 statistics. Statistical significance was defined by a p-value <0.05. Analyses were performed with RevMan 5.4. Results: The meta-analysis included 18 RCTs involving 14,688 patients (7,336 receiving colchicine and 7,352 controls). 11,742 (79.94%) were men and mean age was 59.8±8.8 years. Compared to placebo, colchicine reduced the rate of MACE (RR=0.74, 95%CI:0.60 to 0.92), even when examined after 1 or more years of therapy (RR 0.83, 95%CI:0.70 to 0.98), reduced hsCRP levels (MD -0.80, 95%CI:-1.34 to -0.27), and improved left ventricular ejection fraction (MD 1.13, 95%CI:0.25 to 2.02]). While no increase in overall adverse events was seen with colchicine (RR 1.00, 95% CI: 0.95 to 1.06), diarrhea occurred more frequently (RR=1.52, 95%CI: 1.03 to 2.24). Conclusion: Colchicine appears safe and may improve long-term outcomes in ACS patients. However, larger studies with more extended follow-up are needed for definitive evidence.
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Lanari et al. (2026) conducted a meta-analysis in Acute coronary syndrome (n=14,688). Colchicine vs. Placebo / control was evaluated on Major adverse cardiovascular events (MACE) (RR 0.74, 95% CI 0.60-0.92). Colchicine reduced major adverse cardiovascular events compared to placebo in patients with acute coronary syndrome (RR 0.74; 95% CI 0.60-0.92).
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