Department of Medicine (Cardiology), Veterans Affairs New York Harbor Health Care System, New York, New York; Department of Medicine (Cardiology), New York University School of Medicine, New York, New York.
Department of Medicine (Cardiology), Veterans Affairs New York Harbor Health Care System, New York, New York; Department of Medicine (Cardiology), New York University School of Medicine, New York, New York.
Am J Cardiol. 2023 Oct 1;204:26-28. doi: 10.1016/j.amjcard.2023.07.029. Epub 2023 Aug 1.
Periprocedural inflammation is associated with major adverse cardiovascular events in patients who undergo percutaneous coronary intervention (PCI). In the contemporary era, 5% to 10% of patients develop restenosis, and in the acute coronary syndrome cohort, there remains a 20% major adverse cardiovascular events rate at 3 years, half of which are culprit-lesion related. In patients at risk of restenosis, colchicine has been shown to reduce restenosis when started within 24 hours of PCI and continued for 6 months thereafter, compared with placebo. The Colchicine-PCI trial, which randomized patients to a 1-time loading dose of colchicine or placebo 1 to 2 hours before PCI, showed a dampening of the inflammatory response to PCI but no difference in postprocedural myocardial injury. On mean follow-up of 3.3 years, the incidence of major adverse cardiovascular events did not differ between colchicine and placebo groups (32.5% vs 34.9%; hazard ratio 0.95 [0.68 to 1.34]).
围手术期炎症与接受经皮冠状动脉介入治疗(PCI)的患者发生主要不良心血管事件有关。在当代,5%至 10%的患者发生再狭窄,在急性冠状动脉综合征患者中,3 年内仍有 20%的主要不良心血管事件发生率,其中一半与罪犯病变有关。在有再狭窄风险的患者中,与安慰剂相比,在 PCI 后 24 小时内开始并持续使用 6 个月的秋水仙碱可降低再狭窄率。在 Colchicine-PCI 试验中,患者随机接受单次负荷剂量的秋水仙碱或安慰剂,在 PCI 前 1 至 2 小时给予,结果显示 PCI 后的炎症反应减弱,但术后心肌损伤无差异。平均随访 3.3 年后,秋水仙碱组和安慰剂组的主要不良心血管事件发生率无差异(32.5%比 34.9%;风险比 0.95[0.68 至 1.34])。