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Colchicine in Patients with Chronic Coronary Disease
Open accessAbstract
BACKGROUND: Evidence from a recent trial has shown that the antiinflammatory effects of colchicine reduce the risk of cardiovascular events in patients with recent myocardial infarction, but evidence of such a risk reduction in patients with chronic coronary disease is limited. METHODS: In a randomized, controlled, double-blind trial, we assigned patients with chronic coronary disease to receive 0.5 mg of colchicine once daily or matching placebo. The primary end point was a composite of cardiovascular death, spontaneous (nonprocedural) myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization. The key secondary end point was a composite of cardiovascular death, spontaneous myocardial infarction, or ischemic stroke. RESULTS: A total of 5522 patients underwent randomization; 2762 were assigned to the colchicine group and 2760 to the placebo group. The median duration of follow-up was 28.6 months. A primary end-point event occurred in 187 patients (6.8%) in the colchicine group and in 264 patients (9.6%) in the placebo group (incidence, 2.5 vs. 3.6 events per 100 person-years; hazard ratio, 0.69; 95% confidence interval [CI], 0.57 to 0.83; P<0.001). A key secondary end-point event occurred in 115 patients (4.2%) in the colchicine group and in 157 patients (5.7%) in the placebo group (incidence, 1.5 vs. 2.1 events per 100 person-years; hazard ratio, 0.72; 95% CI, 0.57 to 0.92; P = 0.007). The incidence rates of spontaneous myocardial infarction or ischemia-driven coronary revascularization (composite end point), cardiovascular death or spontaneous myocardial infarction (composite end point), ischemia-driven coronary revascularization, and spontaneous myocardial infarction were also significantly lower with colchicine than with placebo. The incidence of death from noncardiovascular causes was higher in the colchicine group than in the placebo group (incidence, 0.7 vs. 0.5 events per 100 person-years; hazard ratio, 1.51; 95% CI, 0.99 to 2.31). CONCLUSIONS: In a randomized trial involving patients with chronic coronary disease, the risk of cardiovascular events was significantly lower among those who received 0.5 mg of colchicine once daily than among those who received placebo. (Funded by the National Health Medical Research Council of Australia and others; LoDoCo2 Australian New Zealand Clinical Trials Registry number, ACTRN12614000093684.).
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“The efficacy of GLP-1 medications is consistent with actions of other antiinflammatory agents, such as IL-1 antagonists and colchicine, in reducing cardiovascular events (63, 64).”
From Antiinflammatory actions of glucagon-like peptide-1–based therapies beyond metabolic benefits (2025) · cites this paper as [63]
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“The CTTC analysis reported that the benefits of lowering LDL-C level were consistent across a wide spectrum of baseline risk varying from less than 5% to 30% or greater.”
From Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients (2023) · cites this paper as [24]
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“The CTTC analysis showed a 22% reduction in major coronary events for each 38.7-mg/dL (1-mmol/L) decrease in LDL-C level and a 15% reduction in vascular death.”
From Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients (2023) · cites this paper as [24]
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Self-citationBone marrow inflammatory memory in cardiometabolic disease and inflammatory comorbidities
Mitroulis, I., Hajishengallis, G., & Chavakis, T. (2023) · Cardiovascular Research · doi:10.1093/cvr/cvad003 · Cited by 42
“…anti-inflammatory treatment of patients with previous myocardial infarction or patients with chronic coronary disease with colchicine 14,15 or treatment of patients after myocardial infarction that had a C-reactive protein concentration > 2 mg/L with canakinumab, 16 an antibody against…”
BackgroundAdvances in Clinical Imaging of Vascular Inflammation
West, H. W., Dangas, K., & Antoniades, C. A. (2023) · JACC Basic to Translational Science · doi:10.1016/j.jacbts.2023.10.007 · Cited by 38
Pan, W., Zhou, G., Hu, M., Li, G., Zhang, M., Yang, H., Li, K., Li, J., Liu, T., Wang, Y., et al. (2024) · BMC Cardiovascular Disorders · doi:10.1186/s12872-024-03729-x · Cited by 38
Pan-vascular disease: what we have done in the past and what we can do in the future?
Wong, M., Dai, Y., & Ge, J. (2024) · Cardiology Plus · doi:10.1097/cp9.0000000000000078 · Cited by 37
“The CANTOS trial is particularly noteworthy for demonstrating that inhibiting interleukin-1 β can effectively prevent cardiovascular events in individuals with previous myocardial infarctions and elevated high-sensitivity C-reactive protein (hs-CRP) levels [22–25] .”
BackgroundAimo, A., Pascual-Figal, D. A., Bayés‐Genís, A., Emdin, M., & Georgiopoulos, G. A. (2020) · European Journal of Clinical Investigation · doi:10.1111/eci.13464 · Cited by 37
Reiterer, C., Kabon, B., Taschner, A., von Sonnenburg, M. F., Graf, A. C., Adamowitsch, N., Starlinger, P. P., Goschin, J., Fraunschiel, M., & Fleischmann, E. (2021) · Journal of Clinical Anesthesia · doi:10.1016/j.jclinane.2021.110379 · Cited by 37
Pasqualetto, M. C., Tuttolomondo, D., Cutruzzolà, A., Niccoli, G., Dey, D., Greco, A., Martini, C., Irace, C., Rigo, F., & Gaibazzi, N. (2021) · International Journal of Cardiology · doi:10.1016/j.ijcard.2021.05.040 · Cited by 37
Mengozzi, A., Pugliese, N. R., Chiriacò, M., Masi, S., Virdis, A., & Taddei, S. (2021) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0000000000001109 · Cited by 37
Anti-inflammatory therapy in ischaemic heart disease: from canakinumab to colchicine
Andreotti, F., Maggioni, A. P., Campeggi, A., Iervolino, A., Scambia, G., & Massetti, M. (2021) · European Heart Journal Supplements · doi:10.1093/eurheartj/suab084 · Cited by 36
Yalçınkaya, M., Liu, W., Xiao, T., Abramowicz, S., Wang, R., Wang, N., Westerterp, M., & Tall, A. R. (2024) · Journal of Lipid Research · doi:10.1016/j.jlr.2024.100534 · Cited by 41
“Recent clinical studies using IL1 β antibodies (13) or colchicine (14, 15) have shown decreased cardiovascular disease (CVD) events, indicating the importance of inflammatory processes and likely inflammasomes in human CVD.”
NLRP3-mediated inflammation in cardio-oncology: sterile yet harmful
Mauro, A. G., Mezzaroma, E., Toldo, S. A., Meléndez, G. C., Franco, R. L., Lesnefsky, E. J., Abbate, A., Hundley, W. G., & Salloum, F. N. (2022) · Translational research · doi:10.1016/j.trsl.2022.08.004 · Cited by 35
Cardiovascular Risk Estimation and Stratification Among Individuals with Hypercholesterolemia
Bosco, G., Mszar, R., Piro, S., Sabouret, P. F., & Gallo, A. (2024) · Current Atherosclerosis Reports · doi:10.1007/s11883-024-01225-3 · Cited by 39
“Additionally, in individuals suffering from chronic coronary artery disease, the more recent Low-Dose Colchicine-2 (LoDoCo2) trial showcased a 31% decrease in MACE when comparing colchicine treat-ment to placebo [70].”
Immunothrombosis in Acute Ischemic Stroke
Wang, Y., Mulder, I. A., Westendorp, W. F., Coutinho, J. M., & van de Beek, D. (2024) · Stroke · doi:10.1161/strokeaha.124.048137 · Cited by 39
Colchicine and Longitudinal Dynamics of Clonal Hematopoiesis
Mohammadnia, N., Xue, L., Vestjens, L. T. W., Uddin, M. M., Niroula, A., de Kleijn, D. P. V., Mosterd, A., Fiolet, A. T. L., Nakao, T., Eikelboom, J. W., et al. (2025) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2025.08.025 · Cited by 45
“19 A total of 5,522 participants between the ages of 35 and 82 years with chronic coronary artery disease were randomized to receive either colchicine 0.5 mg once daily or matching placebo.”
InfluentialSelf-citationNLRP3 Inflammasome as a Common Denominator of Atherosclerosis and Abdominal Aortic Aneurysm
Takahashi, M. (2021) · Circulation Journal · doi:10.1253/circj.cj-21-0258 · Cited by 36
Karatza, E., Ismailos, G., & Karalis, V. D. (2021) · Xenobiotica · doi:10.1080/00498254.2021.1909782 · Cited by 35
Colchicine and Cardiovascular Outcomes: a Critical Appraisal of Recent Studies
Banach, M., & Penson, P. E. (2021) · Current Atherosclerosis Reports · doi:10.1007/s11883-021-00932-5 · Cited by 35
Chan, Y., & Ramji, D. P. (2022) · Methods in molecular biology · doi:10.1007/978-1-0716-1924-7_1 · Cited by 41
Interleukin-1 in Coronary Artery Disease
Oikonomou, E. K., Tsaplaris, P., Anastasiou, A., Xenou, M., Lampsas, S., Siasos, G., Pantelidis, P., Theofilis, P., Tsatsaragkou, A., Κατσαρού, Ο., et al. (2022) · Current Topics in Medicinal Chemistry · doi:10.2174/1568026623666221017144734 · Cited by 35
Benavente, E. D., Karnewar, S., Buono, M., Mili, E., Hartman, R., Kapteijn, D., Slenders, L., Daniels, M., Aherrahrou, R., Reinberger, T., et al. (2023) · bioRxiv · doi:10.1161/atvbaha.123.319325 · Cited by 23
Li, Q., Huang, Z., Pang, Z., Wang, Q., Gao, J., Chen, J., Wang, Z., Tan, H., Li, S., Xu, F., et al. (2022) · Chemical Engineering Journal · doi:10.1016/j.cej.2022.138992 · Cited by 35
The low-dose colchicine in patients after non-CABG cardiac surgery: a randomized controlled trial
Pan, T., Jiang, C., Zhang, H., Han, X., Zhang, H.-T., Jiang, X., Chen, W., Wang, K., Fan, F.-D., Pan, J., et al. (2023) · Critical Care · doi:10.1186/s13054-023-04341-9 · Cited by 34
“The other low-dose colchicine (LoDoCo2) study showed that colchicine could lower down the risk of cardiovascular events [23].”
BackgroundGallucci, G., Turazza, F. M., Inno, A., Canale, M. L., Silvestris, N., Farì, R., Navazio, A., Pinto, C., & Tarantini, L. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25084232 · Cited by 37
Adaptive immunity and atherosclerosis: aging at its crossroads
Snijckers, R., & Foks, A. C. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1350471 · Cited by 40
“The blocking of IL-1 b with Canakinumab (CANTOS trial) as well as the Low-Dose Colchicine-2 (LoDoCo2) trial have illustrated the effectiveness of modulating in fl ammation for the prevention of atherosclerosis induced CVD events, independent of lipid levels (196, 197).”
d’Entremont, M.-A., Lee, S. F., Mian, R. I., Kedev, S., Montalescot, G., Cornel, J. H., Stankovic, G. R., Moreno, R., Storey, R. F., Henry, T. D., et al. (2024) · American Heart Journal · doi:10.1016/j.ahj.2024.06.007 · Cited by 36
Self-citationInflammatory and Immune Mechanisms for Atherosclerotic Cardiovascular Disease in HIV
Hmiel, L., Zhang, S., Obare, L. M., Santana, M. A. D. O., Wanjalla, C. N., Titanji, B. K., Hileman, C. O., & Bagchi, S. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25137266 · Cited by 34
Cipolletta, E., Nakafero, G., McCormick, N., Yokose, C., Avery, A. J., Mamas, M. A., Choi, H. K., Tata, L. J., & Abhishek, A. (2024) · The Lancet Rheumatology · doi:10.1016/s2665-9913(24)00248-0 · Cited by 40
Asare, Y., Yan, G., Schlegl, C., Prestel, M., van der Vorst, E. P. C., Teunissen, A. J. P., Aronova, A., Tosato, F., Naser, N., Caputo, J., et al. (2025) · Immunity · doi:10.1016/j.immuni.2025.01.003 · Cited by 39
Gao, A., Peng, B., Gao, Y., Yang, Z., Li, Z., Guo, T., Qiu, H., & Gao, R. (2025) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-025-01687-8 · Cited by 34
Slipczuk, L. N., Blankstein, R., Bucciarelli‐Ducci, C., Braun, L. T., Phillips, L. M., Piña, P., Shaw, L. J., Tamis‐Holland, J. E., Williamson, E. E., & Virani, S. S. (2025) · Circulation · doi:10.1161/cir.0000000000001394 · Cited by 38
Mutual Interplay of Host Immune System and Gut Microbiota in the Immunopathology of Atherosclerosis
Yeh, C., Chen, Y.-H., Liu, S.-F., Kao, H., Wu, M., Yang, K., & Wu, W. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21228729 · Cited by 37
Colchicine efficacy and safety for the treatment of cardiovascular diseases
Andreis, A., Imazio, M., Casula, M., Avondo, S., & Ferrari, G. M. D. (2021) · Internal and Emergency Medicine · doi:10.1007/s11739-021-02654-7 · Cited by 34
“Indeed an increased risk of myalgias without creatine kinase elevation was observed in a recent large study [17].”
BackgroundInfluentialInflammation, atrial fibrillation, and the potential role for colchicine therapy
Varghese, B. T., Feldman, D. I., Chew, C., Valilis, E. M., Blumenthal, R. S., Sharma, G. V., & Calkins, H. G. (2021) · Heart Rhythm O2 · doi:10.1016/j.hroo.2021.03.011 · Cited by 34
“Colchicine is an inexpensive anti-inflammatory medication that is commonly used for the treatment of gout and pericarditis.(17) Colchicine works by inhibiting tubulin polymerization and has also been shown to interfere with the NLRP3/ IL-1b signaling pathway.”
BackgroundSzwed, P., Gąsecka, A., Zawadka, M., Eyileten, C., Postula, M. A., Mazurek, T., Szarpak, Ł., & Filipiak, K. J. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10122539 · Cited by 34
Immune-based therapies in cardiovascular and metabolic diseases: past, present and future
Murphy, A. J., & Febbraio, M. A. (2021) · Nature reviews. Immunology · doi:10.1038/s41577-021-00580-5 · Cited by 35
Ueng, K., Chiang, C., Chao, T., Wu, Y., Lee, W.-L., Li, Y., Ting, K.-H., Su, C.-H., Lin, H., Su, T., et al. (2023) · PubMed Central · doi:10.6515/acs.202301_39(1).20221103a · Cited by 34
Association of Low-Dose Colchicine With Incidence of Knee and Hip Replacements
Heijman, M., Fiolet, A., Mosterd, A., Tijssen, J. G., van den Bemt, B. V. D., Schut, A., Eikelboom, J., Thompson, P. L., van den Ende, C. V. D., Nidorf, S., et al. (2023) · Annals of Internal Medicine · doi:10.7326/m23-0289 · Cited by 28
Self-citationGout and Cardiovascular Disease: Mechanisms, Risk Estimations, and the Impact of Therapies
Andrés, M. (2023) · Gout Urate and Crystal Deposition Disease · doi:10.3390/gucdd1030014 · Cited by 36
“In this scenario, two gouty anti-inflammatory agents—colchicine [114–116] and IL-1 β blocker canakinumab [117]—were shown to be effective at preventing CVD in trials.”
BackgroundEndothelial Dysfunction in Atherosclerosis: Experimental Models and Therapeutics
Kopych, V., Costa, A. D. S. D., & Park, K. (2025) · Biomaterials Research · doi:10.34133/bmr.0252 · Cited by 33
“Anti-inflammatory therapies such as canakinumab [ 178 ] and colchicine [ 179 ] could suppress systemic inflammation, regardless of lipid levels.”
Circulatory markers of immunity and carotid atherosclerotic plaque
Fani, L., van Dam-Nolen, D. H. K., Vernooij, M. W., Kavousi, M., van der Lugt, A., & Bos, D. (2021) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2021.03.040 · Cited by 32
Golpour, M., Mousavi, T., Alimohammadi, M., Mosayebian, A., Shiran, M., Alizadeh‐Navaei, R., & Rafiei, A. (2021) · International Journal of Immunopathology and Pharmacology · doi:10.1177/20587384211031763 · Cited by 34
Prevalence and real-world management of NSTEMI with multivessel disease
Baumann, A. A. W., Tavella, R., Air, T., Mishra, A., Montarello, N. J., Arstall, M. A., Zeitz, C. J., Worthley, M. I., Beltrame, J. F., & Psaltis, P. J. (2022) · Cardiovascular Diagnosis and Therapy · doi:10.21037/cdt-21-518 · Cited by 38
“Recent trials of colchicine are promising, though overall mortality benefit is elusive (22,23).”
Background
Metadata
- Authors
- Nidorf, S. M., Fiolet, A. T. L., Mosterd, A., Eikelboom, J. W., Schut, A., Opstal, T. S. J., The, S. H. K., Xu, X.-F., Ireland, M. A., Lenderink, T., Latchem, D., Hoogslag, P., Jerzewski, A., Nierop, P., Whelan, A., Hendriks, R., Swart, H., Schaap, J., Kuijper, A. F. M., van Hessen, M. W. J., Saklani, P., Tan, I., Thompson, A. G., Morton, A., Judkins, C., Bax, W. A., Dirksen, M., Alings, M., Hankey, G. J., Budgeon, C. A., Tijssen, J. G. P., Cornel, J. H., & Thompson, P. L.
- Affiliations
- Sir Charles Gairdner Hospital (AU)
- Gelre Hospitals (NL)
- From GenesisCare Western Australia (S.M.N., X.-F.X., M.A.I., D.L., A.W., R.H., P.S., I.T., A.G.T., A. Morton, P.L.T.), the Heart and Vascular Research Institute (S.M.N., P.L.T.) and the Department of Neurology (G.J.H.), Sir Charles Gairdner Hospital, and the Faculty of Health and Medical Sciences (G.J.H., P.L.T.) and the School of Population and Global Health (C.A.B.), University of Western Australia, Perth, the Department of Cardiology, Fiona Stanley Hospital, Murdoch, WA (C.J.), and the Harry...
- The University of Western Australia (AU)
- Harry Perkins Institute of Medical Research (AU)
- ORCID
- Nidorf, Stefan M.
- Fiolet, Aernoud T.L.
- Mosterd, Arend
- Eikelboom, John W.
- Schut, Astrid
- Opstal, Tjerk S.J.
- Lenderink, Timo
- Schaap, Jeroen
- Kuijper, Aaf F.M.
- Thompson, Angus G.
- Morton, Allison
- Bax, Willem A.
- Dirksen, Maurits
- Alings, Marco
- Hankey, Graeme J.
- Budgeon, Charley A.
- Tijssen, Jan G.P.
- Cornel, Jan H.
- Thompson, Peter L.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2020-11-05
- Volume
- 383
- Issue
- 19
- Pages
- 1838-1847
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W3081761942
- Cited by
- 2,299
- References
- 37
- Citations by year
- 2026: 446 · 2025: 455 · 2024: 388 · 2023: 345 · 2022: 298 · 2021: 311 · 2020: 55
- FWCI
- 155.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- Pure Amsterdam UMC (acceptedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- the National Health Medical Research Council of Australia (NHMRC project grant APP1088455)
- the Withering Foundation the Netherlands
- the Netherlands Organization for Health Research and Development (Grantnr. 848015014)
- the Netherlands Heart Foundation
- Aspen, Australia
- Teva, Haarlem, Disphar, Baarn and Tiofarma, Oud-Beijerland
- Research Advisory Committee of Sir Charles Gairdner Hospital and Osborne ParkGroup and Charlies Foundation for Research
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Keywords
- colchicine, stable coronary artery disease, anti-inflammatory therapy, cardiovascular events, myocardial infarction, ischemic stroke, cardiovascular mortality, coronary revascularization, non-cardiovascular mortality, antiplatelet therapy, statins, coronary artery disease, secondary prevention, cardiovascular risk reduction, cardiovascular risk stratification
- MeSH terms
- Aged, Anti-Inflammatory Agents, Cardiovascular Diseases, Chronic Disease, Colchicine, Coronary Disease, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Middle Aged, Incidence, Proportional Hazards Models, Intention to Treat Analysis
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