Effects of the Low-Dose Colchicine Regimen on Left Ventricular Adverse Remodeling and Systolic Function in Acute Myocardial Infarction Patients With Anterior ST Segment Elevation Undergoing Primary Percutaneous Coronary Intervention: A Randomized Controlled Trial

Fahreza Caesario, Indra Prasetya, Mohammad Saifur Rohman, Budi satrijo, Setyasih Anjarwani


Background: Inflammation in reperfusion injury results in adverse ventricular remodeling and reduced systolic function. The anti-inflammatory effects of colchicine have shown beneficial effects in cardiovascular disease.

Objective: To determine the effects of low-dose colchicine on left ventricular (LV) adverse remodeling and systolic function in acute myocardial infarction with anterior ST-segment elevation (anterior STEMI) patients undergoing primary percutaneous coronary intervention (PPCI).

Material and Methods: This prospective, randomized, double-blinded study randomly assigned anterior STEMI patients who underwent PPCI to receive either low-dose colchicine (1mg loading dose followed by 0.5mg daily) or a matching placebo for 30 days in addition to standard therapy. Outcomes included adverse LV remodeling and systolic function, determined by transthoracic echocardiography (TTE) in the first and third month.

Result: Enrollment comprised 196 patients, with 92 patients in the colchicine group and 104 patients in the placebo group. Adverse LV remodeling and a decrease in systolic function were observed in both groups. No significant differences in LV remodeling were observed between the colchicine and placebo groups, as indicated by the change in LV end-systolic volume index (LVESVI) at the first month (16.5% vs. 18.25% [p=0.091]) and third month (19.5% vs. 21.5% [p=0.124]). Similar results were found in LV systolic function between the colchicine and placebo groups, with a reduction in LV ejection fraction (LVEF) observed in the first month (6.3% vs. 8.95% [p=0.083]) and third month (9.5% vs. 11.5% [p=0.163]). Diarrhea was the only reported side effect, occurring in 6.5% of patients in the colchicine group.

Conclusion: Low-dose colchicine administration in anterior STEMI patients undergoing PPCI did not reduce LV adverse remodeling or systolic function.


Colchicine, STEMI, Reperfusion Injury, Adverse Remodelling, Systolic Function

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Van Tassell B, Talasaz AH, Redlich G, Ziegelaar B, Abbate A. A Real-World Analysis of New-Onset Heart Failure After Anterior Wall ST-Elevation Acute Myocardial Infarction in the United States. Am J Cardiol. 2023;211:245-250. doi:10.1016/j.amjcard.2023.11.037

Hausenloy DJ, Yellon DM. Myocardial ischemia-reperfusion injury: a neglected therapeutic target. Journal of Clinical Investigation. 2013;123(1):92-100. doi:10.1172/JCI62874

Yalta K, Yilmaz MB, Yalta T, Palabiyik O, Taylan G, Zorkun C. Late Versus Early Myocardial Remodeling After Acute Myocardial Infarction: A Comparative Review on Mechanistic Insights and Clinical Implications. J Cardiovasc Pharmacol Ther. 2020;25(1):15-26. doi:10.1177/1074248419869618

González L, Bulnes JF, Orellana MP, Muñoz Venturelli P, Martínez Rodriguez G. The Role of Colchicine in Atherosclerosis: From Bench to Bedside. Pharmaceutics. 2022;14(7):1395. doi:10.3390/pharmaceutics14071395

Akodad M, Sicard P, Fauconnier J, Roubille F. Colchicine and myocardial infarction: A review. Arch Cardiovasc Dis. 2020;113(10):652-659. doi:10.1016/j.acvd.2020.04.007

Zhang FS, He QZ, Qin CH, Little PJ, Weng JP, Xu SW. Therapeutic potential of colchicine in cardiovascular medicine: a pharmacological review. Acta Pharmacol Sin. 2022;43(9):2173-2190. doi:10.1038/s41401-021-00835-w

Deftereos S, Giannopoulos G, Angelidis C, Alexopoulos N, Filippatos G, Papoutsidakis N, et al. Anti-Inflammatory Treatment With Colchicine in Acute Myocardial Infarction. Circulation. 2015;132(15):1395-1403. doi:10.1161/CIRCULATIONAHA.115.017611

Fujisue K, Sugamura K, Kurokawa H, Matsubara J, Ishii M, Izumiya Y, et al. Colchicine Improves Survival, Left Ventricular Remodeling, and Chronic Cardiac Function After Acute Myocardial Infarction. Circulation Journal. 2017;81(8):1174-1182. doi:10.1253/circj.CJ-16-0949

Westman PC, Lipinski MJ, Luger D, Waksman R, Bonow RO, Wu E, et al. Inflammation as a Driver of Adverse Left Ventricular Remodeling After Acute Myocardial Infarction. J Am Coll Cardiol. 2016;67(17):2050-2060. doi:10.1016/j.jacc.2016.01.073

Algoet M, Janssens S, Himmelreich U, Gsell W, Pusovnik M, Van den Eynde J, et al. Myocardial ischemia-reperfusion injury and the influence of inflammation. Trends Cardiovasc Med. 2023;33(6):357-366. doi:10.1016/j.tcm.2022.02.005

Tardif JC, Kouz S, Waters DD, Bertrand OF, Diaz R, Maggioni AP, et al. Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction. New England Journal of Medicine. 2019;381(26):2497-2505. doi:10.1056/NEJMoa1912388

Nidorf SM, Fiolet ATL, Mosterd A, Eikelboom JW, Schut A, Opstal TSJ, et al. Colchicine in Patients with Chronic Coronary Disease. New England Journal of Medicine. 2020;383(19):1838-1847. doi:10.1056/NEJMoa2021372

Satrijo B, Wicaksono Ashari Y, Rohman MS, Anjarwani S, Tjahjono CT. Heart Science Journal Benefits of Low Dosage of Colchicine Administration on Decreasing Rehospitalization and Mortality within 30 Days in Post-Acute Coronary Syndrome Patients with ST-Segment Elevation Undergoing Percutaneous Coronary Intervention. 2023;4(3):28-33. doi:10.21776/ub/hsj.2023.004.03.6

Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-3826. doi:10.1093/eurheartj/ehad191

Hennessy T, Soh L, Bowman M, Kurup R, Schultz C, Patel S, et al. The Low Dose Colchicine after Myocardial Infarction (LoDoCo-MI) study: A pilot randomized placebo controlled trial of colchicine following acute myocardial infarction. Am Heart J. 2019;215:62-69. doi:10.1016/j.ahj.2019.06.003

Mewton N, Roubille F, Bresson D, Prieur C, Bouleti C, Bochaton T, et al. Effect of Colchicine on Myocardial Injury in Acute Myocardial Infarction. Circulation. 2021;144(11):859-869. doi:10.1161/CIRCULATIONAHA.121.056177

Leung YY, Yao Hui LL, Kraus VB. Colchicine—Update on mechanisms of action and therapeutic uses. Semin Arthritis Rheum. 2015;45(3):341-350. doi:10.1016/j.semarthrit.2015.06.013

Imazio M, Nidorf M. Colchicine and the heart. Eur Heart J. 2021;42(28):2745-2760. doi:10.1093/eurheartj/ehab221

Prabhu SD, Frangogiannis NG. The Biological Basis for Cardiac Repair After Myocardial Infarction. Circ Res. 2016;119(1):91-112. doi:10.1161/CIRCRESAHA.116.303577

Toldo S, Mezzaroma E, Mauro AG, Salloum F, Van Tassell BW, Abbate A. The Inflammasome in Myocardial Injury and Cardiac Remodeling. Antioxid Redox Signal. 2015;22(13):1146-1161. doi:10.1089/ars.2014.5989

Dixon DL, Patel J, Spence R, Talasaz AH, Abbate A, Wiggins BS. Select drug-drug interactions with colchicine and cardiovascular medications: A review. Am Heart J. 2022;252:42-50. doi:10.1016/j.ahj.2022.06.002

DOI: https://doi.org/10.21776/ub.hsj.2024.005.02.9


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