Routine colchicine administration after acute myocardial infarction may not improve outcomes, highlights study

The trial was designed with 80% power to detect a 25% relative risk reduction in the primary outcome (9% estimated control event rate) as assessed using a Cox proportional hazards model, stratified by STEMI versus NSTEMI and spironolactone versus placebo.

At a median follow-up of three years, the composite of cardiovascular death, recurrent MI, stroke, or ischemia driven revascularization was not significantly different between the colchicine and placebo groups [9.1 vs. 9.3%, HR 0.99, 95% CI (0.85-1.16), p=0.93]. In addition, there were no significant differences in any of the individual components of the composite endpoint. A significant reduction in C-reactive protein (CRP), a marker for inflammation, was observed with colchicine therapy, however. Adverse events were similar between both study cohorts except that diarrhea was more common after colchicine than with placebo (10.2% vs. 6.6%, p<0.001).

“We designed this trial to provide reliable evidence of the effect of routine colchicine in acute myocardial infarction on clinically important outcomes,” said Sanjit S. Jolly, MD, MSc, principal investigator of the study and scientist at the Population Health Research Institute (PHRI), a joint institute of McMaster University and Hamilton Health Sciences, Canada. “As the largest trial to date on this subject (649 outcome events), with significantly more events than previous studies, colchicine did not provide a significant benefit and its role in long-term post myocardial infarction use is uncertain.”

Reference:

Routine colchicine administration after acute myocardial infarction does not improve outcomes, Cardiovascular Research Foundation, Meeting: TCT 2024: Transcatheter Cardiovascular Therapeutics.