Colchicine helps with plaque stabilization in acute coronary syndrome

In patients with acute coronary syndrome, the use of colchicine appears beneficial in terms of coronary plaque stabilization as assessed on optical coherence tomography, according to a study.

The study included 128 adult patients (mean age 58 years, 25 percent female) with acute coronary syndrome who had lipid-rich plaque (lipid pool arc >90°) detected by optical coherence tomography. These patients were randomly assigned to receive either colchicine 0.5 mg (n=52) or placebo (n=52), administered once daily for 12 months.

Of the patients, 52 in the colchicine group and 52 in the placebo group completed the study. Researchers measured the change in the minimal fibrous cap thickness, the primary study endpoint, from baseline to 12 months.

At 12 months, the minimal fibrous cap thickness was greater following colchicine therapy than after placebo (87.2 vs 51.9 μm; difference, 34.2 μm, 95 percent confidence interval [CI], 9.7–58.6; p=0.006).

Moreover, colchicine was associated with significantly greater reductions in average lipid arc (–35.7° vs –25.2°; difference, –10.5°, 95 percent CI, –17.7 to –3.4; p=0.004), mean angular extension of macrophages (–14.0° vs –8.9°; difference, –6.0°, 95 percent CI, –11.8 to –0.2; p=0.044), high-sensitivity C-reactive protein level (geometric mean ratio, 0.3 vs 0.6; difference, 0.5, 95 percent CI, 0.3–1.0; p=0.046), interleukin-6 level (geometric mean ratio, 0.5 vs 0.8; difference, 0.6, 95 percent CI, 0.4–0.9; p=0.025), and myeloperoxidase level (geometric mean ratio, 0.8 vs 1.0; difference, 0.8, 95 percent CI, 0.6–1.0; p=0.047).