Low-dose colchicine is beneficial for stable or recovering coronary artery disease patients but shows neutral effects in acute myocardial infarction patients post-PCI.
Does colchicine provide cardiovascular benefits across different stages of coronary artery disease?
The efficacy of colchicine in coronary artery disease may depend on the clinical presentation, with benefits seen in stable disease but neutral results in acute myocardial infarction treated with intensive pharmaco-invasive therapies.
Colchicine is an anti-inflammatory drug for different inflammatory conditions and is approved for secondary prevention of cardiovascular events in patients with coronary artery disease, mainly based on the results of the LODOCO2 and COLCOT trials. The recently published CLEAR SYNERGY trial reported neutral results for colchicine in patients with acute myocardial infarction undergoing percutaneous coronary intervention, challenging the previous reported benefits of colchicine. While colchicine appeared rather safe across the different studies, the variation in efficacy may suggest that the one-size-fits-all for the treatment of acute and chronic forms of coronary artery disease may not be appropriate, and that low-dose colchicine may be beneficial as an add-on therapy in patients who are stable or recovering from acute event, and not so helpful in patients with acute myocardial infarction already receiving intensive pharmaco-invasive therapies.
Clary et al. (2025) studied this question. Low-dose colchicine is beneficial for stable or recovering coronary artery disease patients but shows neutral effects in acute myocardial infarction patients post-PCI.