Highlights from

AHA 2019

American Heart Association’s Scientific Sessions

Philadelphia, USA 16 - 18 November 2019

Colchicine: no difference in peri-procedural cardiovascular events 30 days post-PCI

Dr Binita Shah (NYU School of Medicine, USA) presented the 30-day follow-up data of 400 subjects who underwent percutaneous coronary intervention (PCI) in the double-blind, single-site COLCHINE-PCI trial [1].

COLCHICINE-PCI studied pre-procedural use of colchicine in patients with ischaemic heart disease or acute coronary syndrome undergoing PCI. The primary endpoint —myocardial injury, as determined by troponin I concentration— was not different between the 2 arms. In total, 118 subjects assigned to the colchicine arm (57.3%) versus 122 patients in the placebo arm (64.2%) experienced a primary outcome event (P=0.19). Furthermore, no statistically significant distinctions were observed between the colchicine arm versus the placebo arm for any of the secondary endpoints, i.e. peri-procedural myocardial injury using CKMB and the SCAI definition of clinically relevant myocardial infarction after coronary revascularisation or the occurrence of major adverse cardiac events (MACE) with composite of the earliest occurrence of death from any cause, non-fatal myocardial infarction (defined by the Universal Definition), or target vessel revascularisation (bypass surgery or repeat PCI of the target vessel) at 30 days. No differences were observed in all-cause mortality (P=0.49).

In a pre-specified inflammatory marker sub-study with 280 subjects, there was no significant difference for the primary biomarker outcome of soluble interleukin (IL)-6 levels from baseline to 1 hour post-PCI, when comparing the colchicine (n=141) with the placebo (n=139) group. However, at 24 hours post-PCI, IL-6 (76% vs 338%; P=0.02) and high-sensitivity C-reactive protein (7% vs 57%; P=0.001) were both significantly reduced in the colchicine group compared with the placebo group.

In summary, while colchicine appears to attenuate inflammatory cytokine increases during the first 24 hours after PCI, there was no significant difference in peri-procedural myocardial injury or major adverse cardiovascular events at 30 days post-PCI.

Keywords: colchicine; COLCHICINE-PCI; Acute Coronary Syndrome; Percutaneous Coronary Intervention; Coronary Artery Disease; Myocardial Ischaemia

  1. Shah B, et al. Effects of Acute Colchicine Administration Prior to Percutaneous Coronary Intervention: The COLCHICINE-PCI Randomized Trial. LBS04, AHA Scientific Sessions 2019, 14-18 November, Philadelphia, USA.

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