COLIN trial: Value of colchicine in the treatment of patients with acute myocardial infarction and inflammatory response

Akodad, Mariama; Lattuca, Benoît; Nagot, Nicolas; Georgescu, V.; Buisson, Mathilde; Cristol, Jean‐Paul; Leclercq, Florence; Macia, Jean‐Christophe; Gervasoni, Richard; Cung, Thien Tri; Cade, Stéphane; Cransac, F.; Labour, Jessica; Dupuy, Anne‐Marie; Roubille, François

doi:10.1016/j.acvd.2016.10.004

Cited by 88 publications

(115 citation statements)

References 19 publications

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“…A smaller study of 44 patients, however, with a followup of 1 month, randomized patients with STEMI to colchicine 1 mg/d plus OMT or OMT alone and found no difference in mean peak CRP value during the index hospitalization between the 2 groups (Table). 51 In a prospective, observational study of 80 patients with ACS allocated in a 1:1 ratio to OMT alone or OMT with colchicine 0.5 mg/d for 12 months, computed tomography coronary angiography was performed at baseline and 12 months (Table). 8 OMT involved risk factor optimization and statin intensification therapy aiming at an LDL-C level <1.8 mmol/L.…”

Section: The Role Of Colchicinementioning

confidence: 99%

The Role of Colchicine in Acute Coronary Syndromes

Vaidya

Martínez

Patel

2019

Clinical Therapeutics

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Section: The Role Of Colchicinementioning

confidence: 99%

The Role of Colchicine in Acute Coronary Syndromes

Vaidya

Martínez

Patel

2019

Clinical Therapeutics

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“…In the present review, there was an inconsistent effect with respect to lowering of CRP among patients randomized to colchicine therapy 11,12 . Furthermore, two additional studies found no significant difference in CRP levels with colchicine in patients with an acute coronary syndrome 25,26 …”

Section: Discussionmentioning

confidence: 60%

Colchicine for Secondary Cardiovascular Prevention: A Systematic Review

Webb

Barry

2020

Pharmacotherapy

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Despite advancements in medical and interventional therapy, patients with cardiovascular disease (CVD) continue to have residual risk for recurrent cardiovascular events. Colchicine has a unique antiinflammatory mechanism that has generated interest in its potential use as a secondary cardiovascular preventive therapy. The objective of this systematic review was to evaluate the evidence for long-term (6 months or more) colchicine therapy in patients with established CVD. A search of Medline and Embase from inception to February 2020 was performed. Included were randomized controlled trials (RCTs) or propensity score-matched observational studies that compared colchicine (at any dose) with placebo or no treatment. Outcomes of interest included any major adverse cardiovascular event, cardiovascular hospitalization, coronary artery restenosis, cardiovascular death, or all-cause death. Five RCTs were included. The dose of colchicine ranged from 0.5 mg/day to 0.6 mg twice/day, and followup ranged from~6-36 months. Two trials (one double blind and one single blind) showed a reduction in composite outcomes of major adverse cardiovascular events. One study failed to demonstrate a benefit with colchicine in restenosis or recurrent ischemia after angioplasty; however, it was conducted before the routine use of modern percutaneous coronary intervention and medical therapies. In contrast, a more recent trial found that colchicine reduced the rate of in-stent restenosis in patients who received a bare metal stent. Finally, one trial in patients with heart failure with reduced ejection fraction did not observe a benefit in death or heart failure hospitalization with colchicine despite a reduction in inflammatory markers. No trial demonstrated a reduction in cardiovascular or all-cause death, and most trials showed an increase in the rate of diarrhea with colchicine. Overall, colchicine has demonstrated promising results for the secondary prevention of CVD; however, further studies are required to confirm these findings before colchicine can be routinely recommended in practice.

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“…23 This form of HF is characterized by the correlation between adverse clinical events and raised serum/myocardial concentrations of pro-inflammatory cytokines. 24,25 With respect to the pathological mechanism, inflammation has been documented as a critical event in AMI-induced HF. 4,25 Following myocardial infarction, the primary objective of the inflammatory response in the heart is to repair tissue injury, thereby allowing the heart to adapt to the bad conditions in the short-term and ultimately return to homeostasis and recover cardiovascular function in the long-term.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 50% of all HF patients suffer from declined ejection fraction (typically considered as EF <40%) 23 . This form of HF is characterized by the correlation between adverse clinical events and raised serum/myocardial concentrations of pro‐inflammatory cytokines 24,25 . With respect to the pathological mechanism, inflammation has been documented as a critical event in AMI‐induced HF 4,25 .…”

Section: Discussionmentioning

confidence: 99%

Danshen (Salvia miltiorrhiza) restricts MD2/TLR4‐MyD88 complex formation and signalling in acute myocardial infarction‐induced heart failure

Wang

Guo

et al. 2020

J Cellular Molecular Medi

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Heart failure (HF) represents a major public health burden. Inflammation has been shown to be a critical factor in the progression of HF, regardless of the aetiology. Disappointingly, the majority of clinical trials targeting aspects of inflammation in patients with HF have been largely negative. Many clinical researches demonstrate that danshen has a good efficacy on HF, and however, whether danshen exerts anti‐inflammatory effects against HF remains unclear. In our study, the employment of a water extracted and alcohol precipitated of danshen extract attenuated cardiac dysfunction and inflammation response in acute myocardial infarction‐induced HF rats. Transcriptome technique and validation results revealed that TLR4 signalling pathway was involved in the anti‐inflammation effects of danshen. In vitro, danshen reduced the release of inflammatory mediators in LPS‐stimulated RAW264.7 macrophage cells. Besides, the LPS‐stimulated macrophage conditioned media was applied to induce cardiac H9C2 cells injury, which could be attenuated by danshen. Furtherly, knock‐down and overexpression of TLR4 were utilized to confirm that danshen ameliorated inflammatory injury via MyD88‐dependent TLR4‐TRAF6‐NF‐κB signalling pathway in cardiomyocytes. Furthermore, by utilizing co‐immunoprecipitation, danshen was proved to suppress MD2/TLR4 complex formation and MyD88 recruitment. In conclusion, our results demonstrated that danshen ameliorates inflammatory injury by controlling MD2/TLR4‐MyD88 complex formation and TLR4‐TRAF6‐NF‐κB signalling pathway in acute myocardial infarction‐induced HF.

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COLIN trial: Value of colchicine in the treatment of patients with acute myocardial infarction and inflammatory response

Abstract: In our study, the effect of colchicine on inflammation in the context of STEMI could not be demonstrated. Further larger studies may clarify the impact of colchicine in acute myocardial infarction.

Cited by 88 publications

References 19 publications

The Role of Colchicine in Acute Coronary Syndromes

The Role of Colchicine in Acute Coronary Syndromes

Colchicine for Secondary Cardiovascular Prevention: A Systematic Review

Danshen (Salvia miltiorrhiza) restricts MD2/TLR4‐MyD88 complex formation and signalling in acute myocardial infarction‐induced heart failure

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