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Writer's pictureEric Goulder, MD, FACC

Heart Talk - October 2023

Colchicine is a medication well known to many of us. It has been around for years and is often used in the treatment of inflammatory conditions such as pericarditis, skin conditions and gout. However, recent clinical trials have focused on the use of colchicine as a tool to reduce residual inflammation in patients with chronic coronary artery disease who are already being treated with standard medical therapies such as aspirin, statins, and ACE-inhibitors. This is exciting to us for multiple reasons but primarily in its illumination of the importance of inflammation in the progression of otherwise well-managed disease. Low-Dose Colchicine: Another tool in the BDM toolbox


The mechanism of action of colchicine involves mitigating inflammation within the atherosclerotic plaques, stabilizing vulnerable lesions and thus reducing the risk of recurrent cardiovascular events. Colchicine is currently FDA-approved only for the treatment of known disease (secondary or tertiary prevention), not for primary prevention.


A summary of recent studies: COLCOT Trial (2019): The Colchicine Cardiovascular Outcomes Trial was the first to show a significant reduction in MACE (major cardiovascular events), including heart attacks and stroke, among patients with known coronary artery disease (CAD). In this trial, patients treated with lowdose colchicine (0.5mg/day) were compared to placebo.


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