Low-Dose Colchicine for Secondary Prevention of Coronary Artery Disease: JACC Review Topic of the Week (JACC August 2023-2)

Description

Among statin-treated patients, inflammation assessed by high sensitivity C-reactive protein (hsCRP) is a more powerful determinant of cardiovascular death and all-cause mortality than LDL-C. Therapies that target residual inflammatory risk significantly reduce vascular event rates. For coronary artery disease patients already taking guideline directed medical care, low dose colchicine (0.5mg po daily) has been shown to safely lower major adverse cardiovascular events by 31 percent among those with stable atherosclerosis and by 23 percent following recent myocardial infarction. These magnitudes of benefit are larger than that seen in contemporary secondary prevention trials of adjunctive lipid-lowering agents. Low dose colchicine is contraindicated in patients with significant renal or liver dysfunction and should be temporarily discontinued when taking concomitant agents that share metabolism pathways. Based on cost estimates outside the United States, no drugs other than aspirin and statins are more cost-effective than low dose colchicine for secondary prevention.

Editors
Editor-in-Chief
Valentin Fuster, MD, PhD, MACC

CME Editor
Ragavendra R. Baliga, MD

Author
Richard A. Lange, MD, FACC

Important Dates
Date of Release: August 7, 2023
Term of Approval/Date of CME/MOC Expiration: August 6, 2024

Summary


Availability:	Retired


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