Abstract
Myocardial infarction without ST-segment elevation (NSTEMI) is considered an inflammatory disorder associated with a high mortality rate worldwide. High-sensitivity C-reactive protein (hs-CRP) is an important inflammatory marker for NSTEMI and related to cardiovascular events. Colchicine, as a potent anti-inflammatory drug, is frequently prescribed for the treatment of gout and pericarditis. The present study aimed to evaluate the effects of colchicine, as an anti-inflammatory drug, on hs-CRP levels in NSTEMI patients. We performed a randomised, double-blind, placebo-controlled trial involving 150 NSTEMI patients referred to Imam Reza and Ghaem Hospitals affiliated to Mashhad University of Medical Sciences. The patients were randomised to receive colchicine or placebo along with optimal medications for 30 days. The hs-CRP was measured at the admission and end of the study. Our results revealed that, in both colchicine and placebo groups, hs-CRP levels were significantly mitigated in NSTEMI patients compared to baseline (P < 0.001). However, the decreasing properties of colchicine on hs-CRP levels were remarkably stronger than placebo following the 30 days of treatment (P < 0.001). Nevertheless, neither colchicine nor placebo treatment could achieve hs-CRP levels lower than 2 mg/L. There were no significant differences between the effects of colchicine on the hs-CRP decrease in diabetic and non-diabetic, male and female, and normal and preserved LVEF NSTEMI patients. It can be concluded that colchicine may prevent the disease progression and succedent cardiovascular events in NSTEMI patients by attenuating the inflammation.
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Data availability
The data used to support the findings of this study are available from the corresponding author upon reasonable request.
Abbreviations
- ACS:
-
Acute coronary syndrome
- CANTOS:
-
Canakinumab anti-inflammatory thrombosis outcome study
- COLCOT:
-
Colchicine cardiovascular outcomes trial
- Cr:
-
Creatinine
- GFR:
-
Glomerular filtration rate
- HDL:
-
High-density cholesterol
- hs-CRP:
-
High-sensitivity C-reactive protein
- IL-1β:
-
Interleukin-1β
- LVEF:
-
Left ventricular ejection fraction
- LDL:
-
Low-density cholesterol
- LoDoCo:
-
Low-dose colchicine
- LoDoCo-MI:
-
Low-dose colchicine after myocardial infarction
- MPV:
-
Mean platelet volume
- MI:
-
Myocardial infarction
- NSTEMI:
-
Non ST-segment elevation MI
- PMN:
-
Polymorphonuclear
- WBC:
-
White blood cell
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Acknowledgements
This study was financially supported by the research council of Mashhad University of Medical Sciences (grant number 970561).
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This study was financially supported by the grant number 970561 from Mashhad University of Medical Sciences.
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This study was confirmed by the ethics committee of Mashhad University of Medical Sciences (approval code. IR. MUMS. MEDICAL. REC. 1398. 088). Furthermore, this trial was registered at https://www.irct.ir/ (IRCT20190601043780N1).
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Gholoobi, A., Askari, V.R., Naghedinia, H. et al. Colchicine effectively attenuates inflammatory biomarker high-sensitivity C-reactive protein (hs-CRP) in patients with non-ST-segment elevation myocardial infarction: a randomised, double-blind, placebo-controlled clinical trial. Inflammopharmacol 29, 1379–1387 (2021). https://doi.org/10.1007/s10787-021-00865-0
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DOI: https://doi.org/10.1007/s10787-021-00865-0