@article{acf0af267c5b472292740484fb8562b0,
title = "Colchicine in Patients With Chronic Coronary Disease in Relation to Prior Acute Coronary Syndrome",
abstract = "Background: Colchicine reduces risk of cardiovascular events in patients post–myocardial infarction and in patients with chronic coronary disease. It remains unclear whether this effect is related to the time of onset of treatment following an acute coronary syndrome (ACS). Objectives: This study investigates risk for major adverse cardiovascular events in relation to history and timing of prior ACS, to determine whether the benefits of colchicine are consistent independent of prior ACS status. Methods: The LoDoCo2 (Low-Dose Colchicine 2) trial randomly allocated patients with chronic coronary disease to colchicine 0.5 mg once daily or placebo. The rate of the composite of cardiovascular death, spontaneous myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization was compared between patients with no prior, recent (6-24 months), remote (2-7 years), or very remote (>7 years) ACS; interaction between ACS status and colchicine treatment effect was assessed. Results: In 5,522 randomized patients, risk of the primary endpoint was independent of prior ACS status. Colchicine consistently reduced the primary endpoint in patients with no prior ACS (incidence: 2.8 vs 3.4 events per 100 person-years; hazard ratio [HR]: 0.81; 95% confidence interval [CI]: 0.52-1.27), recent ACS (incidence: 2.4 vs 3.3 events per 100 person-years; HR: 0.75; 95% CI: 0.51-1.10), remote ACS (incidence: 1.8 vs 3.2 events per 100 person-years, HR: 0.55; 95% CI: 0.37-0.82), and very remote ACS (incidence: 3.0 vs 4.3 events per 100 person-years, HR: 0.70; 95% CI: 0.51-0.96) (P for interaction = 0.59). Conclusions: The benefits of colchicine are consistent irrespective of history and timing of prior ACS. (The LoDoCo2 Trial: Low Dose Colchicine for secondary prevention of cardiovascular disease [LoDoCo2] ACTRN12614000093684)",
keywords = "anti-inflammatory agents, atherosclerosis, cardiovascular inflammation, ischemic risk, myocardial infarction, secondary prevention",
author = "Opstal, {Tjerk S. J.} and Fiolet, {Aernoud T. L.} and {van Broekhoven}, Amber and Arend Mosterd and Eikelboom, {John W.} and Nidorf, {Stefan M.} and Thompson, {Peter L.} and Michiel Duyvendak and {van Eck}, {J. W. Martijn} and {van Beek}, {Eug{\`e}ne A.} and {den Hartog}, Frank and Budgeon, {Charley A.} and Bax, {Willem A.} and Tijssen, {Jan G. P.} and {el Messaoudi}, Saloua and Cornel, {Jan H.} and {LoDoCo2 Trial Investigators} and Nidorf, {S. M.} and Xu, {X. F.} and Ireland, {M. A.} and D. Latchem and A. Whelan and R. Hendriks and P. Salkani and Tan, {I. W.} and Thompson, {A. G.} and Morton, {A. M.} and Hockings, {B. E.} and Thompson, {P. L.} and B. King and Cornel, {J. H.} and H. Bakker-Lohmeijer and A. Mosterd and P. Bunschoten and The, {S. H. K.} and {van der Kooi}, S. and T. Lenderink and Lardinois, {R. G. J. L.} and Hoogslag, {P. A. M.} and {de Vos}, A. and A. Jerzewski and S. Jansen and Nierop, {P. R.} and {van der Knaap}, M. and Swart, {H. P.} and R. Kingma and J. Schaap and Blom, {L. B.} and {van der Horst}, C. and M. Hendriks and I. Hendriks and Kuijper, {A. F. M.} and E. Bayraktar-Verver",
note = "Funding Information: The authors thank all the patients for their participation in the trial; the trial investigators and coordinators at all the centers; and the trial monitors and staff from GenesisCare (including Penny Buczec, Denny Craig, Karen Doherty, Louise Ferguson, Louise Nidorf, and Karen Youl), the Heart and Vascular Research Institute of Sir Charles Gairdner Hospital (including Louise Ferguson), and the Dutch Network for Cardiovascular Research (including Marjelle van Leeuwen [project manager]; Ingrid Groenenberg and Glentino Rodriguez for data management; Erik Stroes, Max Silvis, and Tim de Vries for medical review; and Petra Bunschoten and Wendy Tousain for site monitoring). Funding Information: This trial was supported by the National Health Medical Research Council of Australia; a grant from the Sir Charles Gairdner Research Advisory Committee; the Withering Foundation (the Netherlands); the Netherlands Heart Foundation; the Netherlands Organization for Health Research and Development; and a consortium of Teva, Disphar, and Tiofarma in the Netherlands. The funders did not have any role in the design or conduct of the study; in the collection, analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript. Dr Mosterd has received grants from Novartis; and has received personal fees from Amarin, Amgen, Bristol Myers Squibb, Boehringer Ingelheim, Merck Sharp and Dohme, and Pfizer. Dr Eikelboom has received consulting/honoraria support from AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Eli Lilly, GlaxoSmithKline, Pfizer, Janssen, Sanofi, and Servier; and has received grants and/or in-kind support from AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, GlaxoSmithKline, Pfizer, Janssen, and Sanofi. Dr Thompson has received grants, travel support, and honoraria from Amarin, Amgen, AstraZeneca, Bristol Myers Squibb, Merck, and Pfizer. Dr Cornel has served on the advisory board for Amgen and AstraZeneca. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: {\textcopyright} 2021 American College of Cardiology Foundation Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = aug,
day = "31",
doi = "https://doi.org/10.1016/j.jacc.2021.06.037",
language = "English",
volume = "78",
pages = "859--866",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "9",
}