Inflammation as a cardiovascular risk factor has attracted increasing attention . The current standard of care for decreasing the occurrence of cardiovascular events includes controlling risk factors such as hypertension and maximizing the lowering of low-density lipoprotein cholesterol (LDL-C). However, a recent study demonstrated decreased cardiovascular risk with the anti-inflammatory agent canakinumab and created more interest in decreasing cardiovascular risk by decreasing inflammation. Canakinumab is not yet approved and will undoubtedly be very expensive, so interest in an established medication such as colchicine, which is inexpensive to produce, is appropriate if evidence-based benefit is adequately confirmed. Colchicine has existing indications for gout and familial Mediterranean fever and for decreasing the incidence of postpericardiotomy syndrome. If an evidence-based benefit in decreasing cardiovascular risk can be demonstrated for colchicine, it will be of significant importance. Meta-analyses and observational studies have provided evidence to suggest that colchicine decreases cardiovascular risk because of its anti-inflammatory effects. However, randomized controlled trials (RCTs) are needed, and the recently published COLCOT (Colchicine Cardiovascular Outcomes Trial) showed definite benefit on cardiovascular outcomes in adults who had experienced a myocardial infarction within the previous 30 days. Sufficient evidence now supports the use of colchicine for secondary prevention in patients at the highest cardiovascular risk who continue to have cardiovascular events despite good blood pressure control and maximum LDL-C reduction. Nevertheless, more RCTs will be necessary before widespread general use of colchicine in cardiovascular disease prevention can be recommended. The current acquisition cost issues with colchicine also need to be resolved.

中文翻译：

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炎症可能是降低心血管风险的未来：秋水仙碱目前有适应症吗？

炎症作为心血管危险因素已引起越来越多的关注。目前减少心血管事件发生的护理标准包括控制高血压等危险因素和最大限度地降低低密度脂蛋白胆固醇 (LDL-C)。然而，最近的一项研究表明，抗炎药 canakinumab 可降低心血管风险，并引起人们对通过减少炎症来降低心血管风险的兴趣。Canakinumab 尚未获得批准，而且无疑会非常昂贵，因此如果充分证实了循证获益，则对生产成本低廉的秋水仙碱等成熟药物感兴趣是合适的。秋水仙碱目前具有治疗痛风和家族性地中海热以及降低心包切开术后综合征发生率的适应症。如果秋水仙碱在降低心血管风险方面的循证益处能够得到证实，那将是非常重要的。荟萃分析和观察性研究提供的证据表明秋水仙碱因其抗炎作用而降低心血管风险。然而，需要随机对照试验 (RCT)，最近发表的 COLCOT（秋水仙碱心血管结局试验）显示，对于在过去 30 天内发生过心肌梗塞的成年人的心血管结局有明确的益处。现在有足够的证据支持在心血管风险最高的患者中使用秋水仙碱进行二级预防，这些患者尽管血压控制良好且 LDL-C 降低幅度最大，但仍继续发生心血管事件。然而，在推荐秋水仙碱广泛用于心血管疾病预防之前，还需要更多的随机对照试验。目前秋水仙碱的获取成本问题也需要解决。