秋水仙碱对ST段抬高型心肌梗死患者心脏重塑和动脉粥样硬化生物标志物的影响：一项随机对照试验。

Colchicine effect on biomarkers of cardiac remodelling and atherosclerosis in ST-elevation myocardial infarction: A randomized controlled trial.

作者信息

Hassanain Hanan Ahmed, El Wakeel Lamia Mohamed, Khorshid Hazem, Ahmed Marwa Adel

机构信息

Ain Shams University Specialized Hospital, Cairo, Egypt.

Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.

出版信息

Br J Clin Pharmacol. 2025 Feb;91(2):427-438. doi: 10.1111/bcp.16270. Epub 2024 Oct 2.

DOI:10.1111/bcp.16270

PMID:39359014

Abstract

AIMS

Owing to its underlying inflammatory nature, atherosclerotic cardiovascular disease remains the leading global cause of mortality, particularly post-ST-elevation myocardial infarction (STEMI), a condition with significant risk for further cardiovascular events and mortality. This study aimed to investigate colchicine's effect on inflammation, cardiac remodelling and atherosclerotic risk in STEMI patients.

METHODS

We conducted a randomized controlled study on 88 STEMI patients undergoing percutaneous coronary intervention. Eligible patients were randomly assigned to 1 of 2 groups. The control group received the guideline-directed medical therapy for STEMI, and the test group received guideline-directed medical therapy and 0.5 mg colchicine twice daily for 3 months. The soluble suppressor of tumorigenicity (sST2), interleukin-1β, lipid profile parameters, triglyceride (TG)/high-density lipoprotein (HDL-C) ratio levels and left ventricular ejection fraction were evaluated for patients at baseline and the end of the 3 months.

RESULTS

No significant effects were reported for colchicine on sST2, interleukin-1β levels or left ventricular ejection fraction. Colchicine significantly lowered TG levels vs. controls, 134 (46-353) vs. 176 (72-825) respectively, P = .02, as well as TG/HDL-C ratio levels, 4.16 (2.75-5.24) vs. 5.11 (3.51-8.33),` respectively, P = .024. sST2 levels of the studied cohort were positively correlated with their TG/HDL-C ratio levels (R = .459, P < .001) at the end of follow-up.

CONCLUSION

Our study highlights a promising impact of colchicine on atherosclerosis and cardiac remodelling factors in STEMI patients. Colchicine significantly reduced TG levels and TG/HDL-C ratio and was safe and well tolerated. Larger long-term studies powered to assess clinical outcomes of remodelling are necessary to confirm its beneficial effects in STEMI.

GOV REGISTRATION ID

NCT06054100.

摘要

目的

由于动脉粥样硬化性心血管疾病具有潜在的炎症性质，它仍然是全球主要的死亡原因，尤其是ST段抬高型心肌梗死（STEMI）后，这种疾病有发生进一步心血管事件和死亡的重大风险。本研究旨在调查秋水仙碱对STEMI患者炎症、心脏重塑和动脉粥样硬化风险的影响。

方法

我们对88例接受经皮冠状动脉介入治疗的STEMI患者进行了一项随机对照研究。符合条件的患者被随机分配到2组中的1组。对照组接受针对STEMI的指南指导药物治疗，试验组接受指南指导药物治疗并每日两次服用0.5毫克秋水仙碱，共3个月。在基线和3个月末对患者的可溶性肿瘤抑制因子（sST2）、白细胞介素-1β、血脂参数、甘油三酯（TG）/高密度脂蛋白（HDL-C）比值水平和左心室射血分数进行评估。

结果

未报告秋水仙碱对sST2、白细胞介素-1β水平或左心室射血分数有显著影响。与对照组相比，秋水仙碱显著降低了TG水平，分别为134（46-353）和176（72-825），P = 0.02，以及TG/HDL-C比值水平，分别为4.16（2.75-5.24）和5.11（3.51-8.33），P = 0.024。在随访结束时，研究队列的sST2水平与其TG/HDL-C比值水平呈正相关（R = 0.459，P < 0.001）。