Low-dose colchicine and high-sensitivity C-reactive protein after myocardial infarction: A combined analysis using individual patient data from the COLCOT and LoDoCo-MI studies

Background: Low-dose colchicine is effective in reducing the risks of recurrent cardiovascular events following an acute myocardial infarction (MI). However, the influence of colchicine on inflammation remains inconclusive. In the current study, we conducted a combined analysis using individual patient data from the COLCOT and LoDoCo-MI trials to assess the effect of low-dose colchicine on high-sensitivity C reactive protein (hs-CRP) in patients with acute MI. Methods: We performed a combined analysis of individual patient data from two clinical trials (COLCOT, LoDoCo-MI). Paired pre-treatment and post-treatment hs-CRP (mg/L) were available in 222 patients for LoDoCo-MI and 207 patients for COLCOT (n(pooled) = 429). We evaluated the effect of colchicine vs. placebo on post-treatment hs-CRP coded continuously and <= 1.0 mg/L in adjusted mixed-model multi-level regression analyses. Results: Colchicine was not significantly associated with post-treatment hs-CRP when it was considered as a continuous variable (beta:-0.41, P = 0.429). However, the intervention was significantly associated with increased odds of achieving post-treatment hs-CRP values <= 1.0 mg/L compared to placebo (odds ratio: 1.64, 95% confidence interval: 1.07 to 2.51, P = 0.024). Conclusions: Reduction of inflammation may be a key component in the clinical efficacy of low-dose colchicine with respect to decreased risk of recurrent cardiovascular events following MI. Systematic sampling of hs-CRP before and after treatment with colchicine may be relevant.

Automated summary

This study conducted a combined analysis of data from the COLCOT and LoDoCo-MI trials to assess the effect of low-dose colchicine on hs-CRP in patients with acute MI. The results showed that low-dose colchicine was not significantly associated with post-treatment hs-CRP as a continuous variable, but it was associated with increased odds of achieving post-treatment hs-CRP values <= 1.0 mg/L. Reduction of inflammation may be a key component in the clinical efficacy of low-dose colchicine for reducing the risk of recurrent cardiovascular events following MI.