The Effect of Colchicine Administration on HsCRP Level and Mean Platelet Volume in Patients with Miocard Acute Infark

Abstract

Background: Patients with coronary heart disease (CHD) who have received standard therapy to the fullest, are still at risk for further cardiovascular events. This is likely because the standard therapy fails to inhibit some inflammatory pathways and platelet aggregation which implies the disease. This study aimed to determine the effect of colchicine on reducing levels of high sensitive c-reactive protein (HsCRP) and mean platelet volume (MPV) in patients with Acute Myocardial Infarction (IMA) in the Intensive Cardiovascular Unit (ICVCU) Dr. Moewardi Hospital, Surakarta. Subjects and Method: Experimental study was conducted with pre and post design. The study was conducted from November 1 to December 31, 2016. A sample of 32 patients with Acute Myocardial Infarction was divided into two groups. The control group was given a placebo and the treatment group was given colchicine 0.5 mg orally for 5 days. Statistical analysis was done using two mean different tests with dependent t-test or Mann-Whitney and two mean analysis paired using independent t test or Wilcoxon. Results:The HsCRP delta level in colchicine group (mean = 3.82; SD = 2.20) was higher than control group (mean = 0.57; SD = 3.12) and it was statistically significant (p<0.001). The delta MPV levels in colchicine group (mean = 2.01; SD = 1.16) were higher than control group (mean = 0.64; SD = 0.83) and it was statistically significant (p = 0.001). Conclusions:The administration of 0.5 mg colchicine by oral for 5 days was associated with levels of HsCRP and MPV among IMA patients.

Efficacy and Safety of Colchicine in Post–acute Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Importantly, the treatment duration of colchicine was heterogeneous across trials. In four of six RCTs ( 18 , 20 , 21 , 23 ), the duration was 30 days or shorter, whereas in the remaining two RCTs ( 19 , 22 ), it was 12 months or longer. The inhomogeneity in the initiation and duration of colchicine in our review raises the need that adequately powered RCTs with earlier and prolonged treatment are required.…”

“…Four trials ( 20 – 23 ) included patients with non–ST-segment elevation MI (NSTEMI) and ST-segment elevation MI (STEMI), whereas in the other two trials ( 18 , 19 ), only STEMI patients were enrolled. Four RCTs were double-blinded ( 19 – 21 , 23 ), one RCT was open-label ( 18 ), and in one, RCT blinding was not specified ( 22 ).…”

“…Doses and treatment duration of colchicine varied among studies. The doses used were 0.5 ( 21 , 22 ) and 1 ( 18 – 20 ) mg/day across five trials with a duration that ranged from 5 days to 24 months. One trial combined both doses ( Table 1 ) ( 23 ).…”

Colchicine for Patients With Coronary Artery Disease: A Systematic Review and Meta-analysis

“…Five among the 6 studies showed significant decrease in CRP levels after the administration of colchicine. 9–13…”

“…28 showed significant decrease in CRP levels after the administration of colchicine. [9][10][11][12][13] Deftereos et al 9 reported that maximal CRP levels measured in the median [interquartile range (IQR)] were 42.9 mg/ L (16.3-71.4) in the treatment group and 63.8 (34.7-103.4) mg/L in control.…”