Tjerk S J Opstal1, Aernoud T L Fiolet2, Amber van Broekhoven3, Arend Mosterd4, John W Eikelboom5, Stefan M Nidorf6, Peter L Thompson7, Michiel Duyvendak8, J W Martijn van Eck9, Eugène A van Beek10, Frank den Hartog11, Charley A Budgeon12, Willem A Bax13, Jan G P Tijssen14, Saloua El Messaoudi3, Jan H Cornel15. 1. Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands. Electronic address: tjerk.opstal@radboudumc.nl. 2. Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands; Dutch Network for Cardiovascular Research, Utrecht, the Netherlands. 3. Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. 4. Dutch Network for Cardiovascular Research, Utrecht, the Netherlands; Department of Cardiology, Meander Medical Center, Amersfoort, the Netherlands. 5. Department of Medicine, McMaster University, Hamilton, Ontario, Canada. 6. Heart and Vascular Research Institute of Western Australia, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; GenesisCare Western Australia, Perth, Western Australia, Australia. 7. Heart and Vascular Research Institute of Western Australia, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia; University of Western Australia, Perth, Western Australia, Australia. 8. Department of Clinical Pharmacy, Antonius Hospital Sneek, Sneek, the Netherlands; Pharmacy D&A Research, Sneek, the Netherlands. 9. Department of Cardiology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands. 10. Department of Cardiology, St Jansdal Hospital, Harderwijk, the Netherlands. 11. Department of Cardiology, Gelderse Vallei Hospital, Ede, the Netherlands. 12. University of Western Australia, Perth, Western Australia, Australia. 13. Department of Internal Medicine, Northwest Clinics, Alkmaar, the Netherlands. 14. Department of Cardiology, Amsterdam University Medical Center, Amsterdam, the Netherlands; Cardialysis BV, Rotterdam, the Netherlands. 15. Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands; Dutch Network for Cardiovascular Research, Utrecht, the Netherlands.
Abstract
BACKGROUND: Colchicine reduces risk of cardiovascular events in patients post-myocardial infarction and in patients with chronic coronary disease. It remains unclear whether this effect is related to the time of onset of treatment following an acute coronary syndrome (ACS). OBJECTIVES: This study investigates risk for major adverse cardiovascular events in relation to history and timing of prior ACS, to determine whether the benefits of colchicine are consistent independent of prior ACS status. METHODS: The LoDoCo2 (Low-Dose Colchicine 2) trial randomly allocated patients with chronic coronary disease to colchicine 0.5 mg once daily or placebo. The rate of the composite of cardiovascular death, spontaneous myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization was compared between patients with no prior, recent (6-24 months), remote (2-7 years), or very remote (>7 years) ACS; interaction between ACS status and colchicine treatment effect was assessed. RESULTS: In 5,522 randomized patients, risk of the primary endpoint was independent of prior ACS status. Colchicine consistently reduced the primary endpoint in patients with no prior ACS (incidence: 2.8 vs 3.4 events per 100 person-years; hazard ratio [HR]: 0.81; 95% confidence interval [CI]: 0.52-1.27), recent ACS (incidence: 2.4 vs 3.3 events per 100 person-years; HR: 0.75; 95% CI: 0.51-1.10), remote ACS (incidence: 1.8 vs 3.2 events per 100 person-years, HR: 0.55; 95% CI: 0.37-0.82), and very remote ACS (incidence: 3.0 vs 4.3 events per 100 person-years, HR: 0.70; 95% CI: 0.51-0.96) (P for interaction = 0.59). CONCLUSIONS: The benefits of colchicine are consistent irrespective of history and timing of prior ACS. (The LoDoCo2 Trial: Low Dose Colchicine for secondary prevention of cardiovascular disease [LoDoCo2] ACTRN12614000093684).
BACKGROUND: Colchicine reduces risk of cardiovascular events in patients post-myocardial infarction and in patients with chronic coronary disease. It remains unclear whether this effect is related to the time of onset of treatment following an acute coronary syndrome (ACS). OBJECTIVES: This study investigates risk for major adverse cardiovascular events in relation to history and timing of prior ACS, to determine whether the benefits of colchicine are consistent independent of prior ACS status. METHODS: The LoDoCo2 (Low-Dose Colchicine 2) trial randomly allocated patients with chronic coronary disease to colchicine 0.5 mg once daily or placebo. The rate of the composite of cardiovascular death, spontaneous myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization was compared between patients with no prior, recent (6-24 months), remote (2-7 years), or very remote (>7 years) ACS; interaction between ACS status and colchicine treatment effect was assessed. RESULTS: In 5,522 randomized patients, risk of the primary endpoint was independent of prior ACS status. Colchicine consistently reduced the primary endpoint in patients with no prior ACS (incidence: 2.8 vs 3.4 events per 100 person-years; hazard ratio [HR]: 0.81; 95% confidence interval [CI]: 0.52-1.27), recent ACS (incidence: 2.4 vs 3.3 events per 100 person-years; HR: 0.75; 95% CI: 0.51-1.10), remote ACS (incidence: 1.8 vs 3.2 events per 100 person-years, HR: 0.55; 95% CI: 0.37-0.82), and very remote ACS (incidence: 3.0 vs 4.3 events per 100 person-years, HR: 0.70; 95% CI: 0.51-0.96) (P for interaction = 0.59). CONCLUSIONS: The benefits of colchicine are consistent irrespective of history and timing of prior ACS. (The LoDoCo2 Trial: Low Dose Colchicine for secondary prevention of cardiovascular disease [LoDoCo2] ACTRN12614000093684).
Authors: Spyridon G Deftereos; Frans J Beerkens; Binita Shah; George Giannopoulos; Dimitrios A Vrachatis; Sotiria G Giotaki; Gerasimos Siasos; Johny Nicolas; Clare Arnott; Sanjay Patel; Mark Parsons; Jean-Claude Tardif; Jason C Kovacic; George D Dangas Journal: Circulation Date: 2021-12-29 Impact factor: 29.690
Authors: Camila Helena Aguiar Bôtto-Menezes; Izabella Picinin Safe; Ana Cláudia da Cunha Ferreira; Katia do Nascimento Couceiro; Armando Menezes Neto; Rafael Freitas Oliveira Franca; Guilherme Amaral Calvet; Ana Maria Bispo de Filippis; Edna Oliveira Kara; Marcia da Costa Castilho; Michele Souza Bastos; Carlos Alexandre Antunes de Brito; Kayvon Modjarrad; Nathalie Jeanne Nicole Broutet; Patrícia Brasil; Ludhmila Abrahão Hajjar; Marcus Vinícius Guimarães de Lacerda Journal: BMC Infect Dis Date: 2022-05-31 Impact factor: 3.667