Colchicine efficacy and safety for the treatment of cardiovascular diseases

Andreis, Alessandro; Imazio, Massimo; Casula, Matteo; Avondo, Stefano; Ferrari, Gaetano Maria De

doi:10.1007/s11739-021-02654-7

“…Long-term use of low doses of colchicine is relatively safe; the dose only requires adjustment if creatinine levels reach 2 mg/dL (eGFR ≈ 30–50 mL/min/1.73 m 2 ) 41 . Moreover, P4P for the DM multiple disciplinary team is key to monitoring creatinine level fluctuations in DM patients and facilitates recovery of renal function in patients using colchicine 42 . These strict policies reduce the influence of the confounding factor of renal function impairment on stroke risks in the DM cohort.…”

Section: Resultsmentioning

confidence: 99%

Effects of colchicine use on ischemic and hemorrhagic stroke risk in diabetic patients with and without gout

Yeh

¹

,

Kuo

²

,

Yip

³

et al. 2022

Sci Rep

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This study aimed to determine the effect of colchicine use on the risk of stroke among patients with diabetes mellitus (DM). We retrospectively enrolled patients with DM between 2000 and 2013 from the Longitudinal Health Insurance Database and divided them into a colchicine cohort (n = 8761) and noncolchicine cohort (n = 8761) by using propensity score matching (PSM). The event of interest was a stroke, including ischemic stroke and hemorrhagic stroke. The incidence of stroke was analyzed using multivariate Cox proportional hazards models between the colchicine cohort and the comparison cohort after adjustment for several confounding factors. The subdistribution hazard model was also performed for examination of the competing risk. The colchicine cohort had a significantly lower incidence of stroke [adjusted hazard ratios (aHR), 95% confidence intervals (95%CI)] (aHR = 0.61, 95%CI = 0.55–0.67), ischemic stroke (aHR = 0.59, 95%CI = 0.53–0.66), and hemorrhagic stroke (aHR = 0.66, 95%CI = 0.53–0.82) compared with the noncolchicine cohort. Drug analysis indicated that patients in the colchicine cohort who received colchicine of cumulative daily defined dose (cDDD) > 14 and duration > 28 days had a lower risk of stroke and ischemic stroke compared with nonusers. The colchicine cohort (cDDD > 150, duration > 360 days) also had a lower risk of stroke, ischemic stroke, and hemorrhagic stroke. The cumulative incidence of stroke, ischemic stroke, and hemorrhagic stroke in the colchicine cohort was significantly lower than that in the noncolchicine cohort (log-rank P < 0.001). However, the subdistribution hazard model reveal the colchicine was not associated with the hemorrhagic stroke in DM patients without gout (aHR = 0.69, 95%CI = 0.47–1.00). Colchicine use with cDDD > 14 and duration > 28 days was associated with lower risk of stroke and ischemic stroke, and colchicine use with cDDD > 150 and duration > 360 days played an auxiliary role in the prevention of stroke, ischemic stroke, and hemorrhagic stroke in patients with DM. The colchicine for the hemorrhagic stroke in DM patients without gout seem to be null effect.

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“…There is a causal relation between CRP and the pathogenesis of ACS [ 19 – 21 ]. The application of anti-inflammatory drugs (such as colchicine) can reduce the risk of cardiovascular events, which also confirmed that inflammation is involved in the occurrence and development of ACS [ 22 , 23 ]. Our previous study confirmed that CRP was an independent predictor of young females with ACS [ 24 ].…”

Section: Discussionmentioning

confidence: 81%

C‐Reactive Protein Level Predicts Cardiovascular Risk in Chinese Young Female Population

Liu

¹

,

Xu

²

,

Ma

³

et al. 2021

Oxidative Medicine and Cellular Longevity

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Background. C-reactive protein (CRP) is one of the most common oxidative indexes affected by many diseases. In recent years, there have been many studies on CRP, but the relationship between CRP levels and the cardiovascular risk in the Chinese young female population is still unclear. The purpose of this work is to explore the predictive value of CRP for the cardiovascular risk in the Chinese young female population. Methods. The study is conducted by 1 : 1 case-control to retrospectively analyze 420 young women with acute coronary syndrome (ACS group) who underwent percutaneous coronary intervention (PCI) and 420 young women (control group) who underwent coronary angiography (CAG) to exclude coronary heart disease from January 2007 to December 2016. All patients are divided into three subgroups according to CRP values: subgroup 1: CRP < 1.0 mg / L ( n = 402 ); subgroup 2: 1.0 mg / L ≤ CRP ≤ 3.0 mg / L ( n = 303 ); subgroup 3: CRP > 3.0 mg / L ( n = 135 ). The levels of CRP were observed in the two groups and three subgroups. Results. A total of 840 patients were analyzed. The mean duration of follow-up was 66.37 ± 30.06 months. The results showed that the level of CRP in the ACS group was significantly higher than that in the control group ( 1.30 ± 1.70 vs. 3.33 ± 5.92 , respectively, p < 0.001 ), and patients with higher CRP levels were associated with a significantly increased rate of major adverse cardiovascular events (MACE) (7.0% vs. 8.9% vs. 19.30%, respectively, p < 0.05 ). After adjustment for baseline covariates, CRP level was still an independent predictor for the incidence of MACE, either as a continuous variable or as a categorical variable. There was a significantly higher rate of all-cause mortality and myocardial infarction in patients with higher CRP values during follow-up. Conclusions. The research results show that high CRP is associated with increased risk of ACS in the Chinese young female population. Risk stratification with CRP as an adjunct to predict clinical risk factors might be useful in the Chinese young female population.

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“…As mention before, pathological-microbiological evidence, biological plausibility, animal models, and clinical evidence indicated the virus related with—pericarditis, myocarditis, endocarditis, cardiomyopathy, cardiac arrhythmia, and heart failure could be lumped as a group. Meanwhile, from the biological plausibility, colchicine has effects on the HD ( 10 , 17 , 28 ). These disorders are combined into one category of HD ( ICD-9-CM codes 420–428) ( 29 , 30 ).…”

Section: Methodsmentioning

confidence: 99%

Colchicine Is a Weapon for Managing the Heart Disease Among Interstitial Lung Disease With Viral Infection: Have We Found the Holy Grail?

Yeh

¹

,

Hung

²

,

Lin

³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundThis study investigated the effect of colchicine use on the risks of heart disease (HD), pericarditis, endocarditis, myocarditis, cardiomyopathy, cardiac arrhythmia, and cardiac failure in patients having interstitial lung disease (ILD) with virus infection (ILD cohort).MethodsWe retrospectively enrolled ILD cohort between 2000 and 2013 from the Longitudinal Health Insurance Database and divided them into colchicine users (n = 12,253) and colchicine non-users (n = 12,253) through propensity score matching. The event of interest was the diagnosis of HD. The incidence of HD was analyzed using multivariate Cox proportional hazards models between colchicine users and the comparison cohort after adjustment for age, sex, medication, comorbidities, and index date based on the time-dependent analysis.ResultsColchicine users had a significantly lower risk of HD (aHR = 0.87, 95% confidence interval (CI]) = 0.82–0.92) than did the colchicine non-user. For colchicine non-users as the reference, the aHR (95% CI) of the patients who received colchicine of 2–7, 8–30, 31–150, and > 150 days were 0.89 (0.81–0.98), 0.84 (0.76–0.94), 090 (0.80–0.99), and 0.83 (0.74–0.93), respectively; regardless of duration use, the lower risk of HD persisted in colchicine users. The cumulative incidence of HD in colchicine users was significantly lower than that in the colchicine non-users (log-rank p < 0.001).ConclusionThe addition of short-term or long-term colchicine to standard medical therapy may have benefits to prevent the HD among the ILD patients concurrent with a virus infection or comorbidities even in elderly patients.

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Colchicine efficacy and safety for the treatment of cardiovascular diseases

Cited by 21 publications

References 51 publications

Effects of colchicine use on ischemic and hemorrhagic stroke risk in diabetic patients with and without gout

Effects of colchicine use on ischemic and hemorrhagic stroke risk in diabetic patients with and without gout

C‐Reactive Protein Level Predicts Cardiovascular Risk in Chinese Young Female Population

Colchicine Is a Weapon for Managing the Heart Disease Among Interstitial Lung Disease With Viral Infection: Have We Found the Holy Grail?

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