Effect of Colchicine on Myocardial Injury in Acute Myocardial Infarction

Media type: E-Article
Title: Effect of Colchicine on Myocardial Injury in Acute Myocardial Infarction
Contributor: Mewton, Nathan; Roubille, François; Bresson, Didier; Prieur, Cyril; Bouleti, Claire; Bochaton, Thomas; Ivanes, Fabrice; Dubreuil, Olivier; Biere, Loïc; Hayek, Ahmad; Derimay, François; Akodad, Mariama; Alos, Benjamin; Haider, Lamis; El Jonhy, Naoual; Daw, Rachel; De Bourguignon, Charles; Dhelens, Carole; Finet, Gérard; Bonnefoy-Cudraz, Eric; Bidaux, Gabriel; Boutitie, Florent; Maucort-Boulch, Delphine; Croisille, Pierre; [...]
imprint: Ovid Technologies (Wolters Kluwer Health), 2021
Published in: Circulation
Language: English
DOI: 10.1161/circulationaha.121.056177
ISSN: 0009-7322; 1524-4539
Keywords: Physiology (medical) ; Cardiology and Cardiovascular Medicine
Origination:
Footnote:
Description: <jats:sec> <jats:title>Background:</jats:title> <jats:p>Inflammation is a key factor of myocardial damage in reperfused ST-segment–elevation myocardial infarction. We hypothesized that colchicine, a potent anti-inflammatory agent, may reduce infarct size (IS) and left ventricular (LV) remodeling at the acute phase of ST-segment–elevation myocardial infarction.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>In this double-blind multicenter trial, we randomly assigned patients admitted for a first episode of ST-segment–elevation myocardial infarction referred for primary percutaneous coronary intervention to receive oral colchicine (2-mg loading dose followed by 0.5 mg twice a day) or matching placebo from admission to day 5. The primary efficacy outcome was IS determined by cardiac magnetic resonance imaging at 5 days. The relative LV end-diastolic volume change at 3 months and IS at 3 months assessed by cardiac magnetic resonance imaging were among the secondary outcomes.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> We enrolled 192 patients, 101 in the colchicine group and 91 in the control group. At 5 days, the gadolinium enhancement–defined IS did not differ between the colchicine and placebo groups with a mean of 26 interquartile range (IQR) [16–44] versus 28.4 IQR [14–40] g of LV mass, respectively ( <jats:italic>P</jats:italic> =0.87). At 3 months follow-up, there was no significant difference in LV remodeling between the colchicine and placebo groups with a +2.4% (IQR, –8.3% to 11.1%) versus –1.1% (IQR, –8.0% to 9.9%) change in LV end-diastolic volume ( <jats:italic>P</jats:italic> =0.49). Infarct size at 3 months was also not significantly different between the colchicine and placebo groups (17 IQR [10–28] versus 18 IQR [10–27] g of LV mass, respectively; <jats:italic>P</jats:italic> =0.92). The incidence of gastrointestinal adverse events during the treatment period was greater with colchicine than with placebo (34% versus 11%, respectively; <jats:italic>P</jats:italic> =0.0002). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>In this randomized, placebo-controlled trial, oral administration of high-dose colchicine at the time of reperfusion and for 5 days did not reduce IS assessed by cardiac magnetic resonance imaging.</jats:p> </jats:sec> <jats:sec> <jats:title>Registration:</jats:title> <jats:p> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://www.clinicaltrials.gov">https://www.clinicaltrials.gov</jats:ext-link> ; Unique identifier: NCT03156816. </jats:p> </jats:sec>
Access State: Open Access

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