Shaikh Safia, Hamza Mohammad, Neppala Sivaram, Singh Sahib, Upreti Prakash, Umer Ahmed Muaaz, Manish K C, Pandya Krutarth, Bahar Yasemin, Sattar Yasar, Alraies M Chadi
Washington University in St Louis, St Louis, MO, USA.
Guthrie Medical Group, Cortland, NY, USA.
Int J Cardiol. 2025 Apr 15;425:133045. doi: 10.1016/j.ijcard.2025.133045. Epub 2025 Feb 7.
Despite optimal therapy, coronary artery disease (CAD) remains a significant public health concern worldwide. Studies have increasingly recognized the role of inflammation in atherosclerosis. Colchicine, a potent anti-inflammatory drug commonly used to treat gout, and pericarditis is being evaluated in this study for its safety and efficacy in preventing CAD following an acute coronary syndrome (ACS).
We searched PubMed and Embase for studies up to April 2024 comparing colchicine to standard medical treatment in ACS patients. Primary outcomes included major adverse cardiovascular events (MACE) and recurrent ACS, while secondary outcomes were cardiovascular death, congestive heart failure (CHF), stroke, hospitalizations, and gastrointestinal (GI) side effects. Data were pooled using a random-effects model.
We included nine studies with a pooled sample size of 7260 patients. The mean age was 60.1 (±11.8) years, with 19.3 % females and a mean follow-up duration of 8.5 (±6) months. Patients who received colchicine treatment demonstrated a reduced risk of re-hospitalizations (OR 0.52 [0.34-0.81]) but had increased GI effects (OR 2.10 [1.20-3.68]). There was no significant difference in cardiovascular death (OR 1.17 [0.52-2.63]), MACE (OR 0.68 [0.45-1.01]), stroke (OR 0.46 [0.18-1.18]), recurrent ACS (OR 0.55 [0.28-1.09]) and the incidence of CHF (OR 0.90 [0.38-2.12]) between patients treated with colchicine versus standard medical treatment.
Adding colchicine to standard medical therapy in ACS patients significantly reduced hospitalizations but is associated with increased GI side effects. Further prospective trials are required to validate these findings and determine if early intervention with colchicine treatment improves clinical outcomes in ACS patients.
尽管进行了最佳治疗，但冠状动脉疾病（CAD）仍是全球重大的公共卫生问题。研究越来越认识到炎症在动脉粥样硬化中的作用。秋水仙碱是一种常用的治疗痛风和心包炎的强效抗炎药物，本研究正在评估其在预防急性冠状动脉综合征（ACS）后CAD方面的安全性和有效性。
我们检索了截至2024年4月的PubMed和Embase数据库，以查找比较秋水仙碱与ACS患者标准药物治疗的研究。主要结局包括主要不良心血管事件（MACE）和复发性ACS，次要结局为心血管死亡、充血性心力衰竭（CHF）、中风、住院和胃肠道（GI）副作用。使用随机效应模型汇总数据。
我们纳入了9项研究，汇总样本量为7260例患者。平均年龄为60.1（±11.8）岁，女性占19.3%，平均随访时间为8.5（±6）个月。接受秋水仙碱治疗的患者再次住院风险降低（OR 0.52 [0.34 - 0.81]），但胃肠道不良反应增加（OR 2.10 [1.20 - 3.68]）。秋水仙碱治疗组与标准药物治疗组在心血管死亡（OR 1.17 [0.52 - 2.63]）、MACE（OR 0.68 [0.45 - 1.01]）、中风（OR 0.46 [0.18 - 1.18]）、复发性ACS（OR 0.55 [0.28 - 1.09]）和CHF发生率（OR 0.90 [0.38 - 2.12]）方面无显著差异。
在ACS患者的标准药物治疗中添加秋水仙碱可显著减少住院次数，但与胃肠道副作用增加有关。需要进一步的前瞻性试验来验证这些发现，并确定秋水仙碱早期干预是否能改善ACS患者的临床结局。
