The Efficacy of Low Dose Colchicine in Patients with Acute Myocardial Infarction
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Abstract
Background: The main cause of acute myocardial infarction (AMI) is atheromatous plaque rupture or erosion, which later stimulates clotting systems and leads to a partial or complete blockage of a coronary artery. Additionally, systemic inflammatory response is also a recognized factor correlated with AMI. A persistent elevated level of circulating inflammatory markers like C-reactive protein (CRP) increases the risk of further unfavorable cardiovascular outcomes after AMI. Colchicine, an anti-inflammatory medication, has been found to minimize cardiovascular events in people who have had a recent myocardial infarction.
Objective: To evaluate the efficiency of low-dose colchicine on inflammation compared to placebo in patients with acute myocardial infarction who received primary percutaneous coronary intervention (PPCI).
Methods: A randomized, controlled, double-blind study that included 36 patients, aged between 18 and 80 years old, who were diagnosed with acute myocardial infarction and successfully treated with percutaneous coronary intervention at Surin hospital was carried out. The patients were assigned to receive either colchicine 0.6 mg once daily or placebo for a month. All patients received an optimal medical treatment following guideline. C-reactive protein (CRP), left ventricular ejection fraction (LVEF) and side effects from the medication were assessed for 3 months.
Results: When comparing between 0.6 mg of colchicine and the placebo administered to the patients,there was no statistically difference in CRP level from the start of the study, day 3, day 14 and day 30 (p = 0.96, 0.52, 0.59, and 0.30, respectively). Furthermore, there was also no difference in left ventricular ejection fraction at day 1, day 14, day 30, and day 90 as well (p = 0.72, 0.88, 0.18, and 0.28, respectively).Similarly, therewere no differences in the side effects of the drugs
Conclusions: From this study, the efficacy of colchicine oninflammatory responsecompared to placebo inpatients with acute myocardial infarction treated with percutaneous coronary intervention could not be demonstrated. Furthermore, there was no difference in left ventricular ejection fraction between the two groups.
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