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Colchicine for Secondary Prevention of Cardiovascular Disease

  • Coronary Heart Disease (JA Farmer, Section Editor)
  • Published:
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Abstract

Preliminary evidence demonstrating that adding 0.5 mg of colchicine per day to statin and antiplatelet therapy reduced the risk of acute coronary events in patients with stable coronary artery disease has raised the hope that it may prove effective for the long-term secondary prevention of cardiovascular disease. The ability of colchicine to suppress blood levels of inflammatory mediators and prevent cholesterol-crystal-induced neutrophil-mediated inflammation implicated in the progression and instability of atherosclerosis adds plausibility to this clinical observation. Early intestinal intolerance in some patients is well recognized, but clinical experience gained over more than half a century with the continuous use of colchicine for the prevention of neutrophil-mediated inflammation in patients with familial Mediterranean fever and gout indicates that low-dose long-term therapy is safe. Nonetheless, before colchicine can be recommended for the secondary prevention of cardiovascular disease, further studies are required to confirm its safety and efficacy in a broad range of patients with coronary disease, and to determine whether doses of colchicine less than 0.5 mg/day might be effective and even better tolerated. Trials exploring the role of colchicine in the treatment of patients with acute coronary syndromes would also be of special interest but may require the use of doses higher than those used for long-term secondary prevention.

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Conflict of Interest

Stefan M. Nidorf and Peter L. Thompson declare that they have no conflict of interest.

John W. Eikelboom is a consultant to AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly, GlaxoSmithKline, Pfizer, Jansen, and Sanofi-Aventis.

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  1. Heart Care Western Australia, 3/140 Mounts Bay Rd, Perth, WA, 6000, Australia

    Stefan M. Nidorf

  2. McMaster University, Hamilton, ON, L8S 4 L8, Canada

    John W. Eikelboom

  3. Heart Research Institute of Western Australia, Sir Charles Gairdner Hospital, University of Western Australia, Perth, WA, 6009, Australia

    Peter L. Thompson

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  1. Stefan M. Nidorf
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Nidorf, S.M., Eikelboom, J.W. & Thompson, P.L. Colchicine for Secondary Prevention of Cardiovascular Disease. Curr Atheroscler Rep 16, 391 (2014). https://doi.org/10.1007/s11883-013-0391-z

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