2020 in a nutshell: The hottest developments in the field of cardiology this year. Section 1. General and preventive cardiology

3. LoDoCo2 (Low-Dose Colchicine vs. Placebo in Patients With Chronic Coronary Disease)trial :Colchicine protective in chronic coronary disease.

Enrolling from Australia and the Netherlands, LoDoCo2 investigators studied 5,522 participants who had chronic CAD (any evidence on invasive or CT angiography or a coronary artery calcium score of ≥ 400 Agatston units) and had been clinically stable for at least 6 months, randomizing them to colchicine 0.5 mg or placebo.

Over a median follow-up duration of 28.6 months, primary endpoint events (CV death, nonprocedural MI, ischemic stroke, or ischemia-driven coronary revascularization) were decreased with colchicine (6.8%) compared with placebo (9.6%). These rates amounted to an incidence of 2.5 events per 100-person years for colchicine and 3.6 events per 100 person-years for placebo (HR 0.69; 95% CI 0.57-0.83). Results were consistent across subgroups.While these findings support the growing body of evidence of the role of inflammation in cardiovascular disease, the study failed to monitor levels of inflammatory markers. Only 15% of the participants were women, a shortcoming that needs to be addressed in future trials. There is some concern regarding GI intolerance of colchicine, and drug interactions need to be carefully explored."Over a decade, more than one in three heart patients will have another heart attack or stroke, or die from heart disease, despite taking preventive medication," said study author Dr. Mark Nidorf of GenesisCare, Australia. "Our study shows that this could be reduced to one in four with the addition of low-dose colchicine.LoDoCo2 provides strong evidence to support repurposing colchicine for routine secondary prevention in patients with chronic coronary disease," added Mark Nidorf in a press briefing. Source: American heart journal: Nidorf SM, Fiolet ATL,et al The LoDoCo2 trial rationale, design, and baseline characteristics. Am Heart J. 2019 Dec; 218:46-56. doi: 10.1016/j.ahj.2019.09.011.