A study by Gonzalo Martınez et al., published in the Journal of the American Heart Association indicates that colchicine may also be useful for the treatment of heart attacks by reducing cardiac inflammation and the local pro-inflammatory cytokine production.
The drug has several potential mechanisms of action, including reducing the chemotaxis of neutrophils, inhibiting inflammasome signaling, and decreasing the production of cytokines, such as interleukin-1 beta.
Recently, the drug has been shown to potentially reduce the risk of cardiovascular events in those with coronary artery disease.
Given that canakinumab has not been approved for cardiovascular prevention, the search for a widely used alternative antiinflammatory treatment that may reduce the risk of atherosclerotic events among patients with coronary artery disease continues.
In the study published in the Journal of the American Heart Association, the international research team from Australia, Chile, France and the UK found that colchicine given to patients with acute coronary syndrome, the day before a cardiac catheterization, significantly reduced the intracardiac release of interleukin (IL)-1β, IL-18, and IL-6.
These cytokines are major players in atherosclerotic inflammation, and contribute to the atherosclerotic plaque development, progression and destabilization.
This study may suggest a new treatment strategy that could reduce the incidence of new coronary events, which are common after acute coronary syndrome.
In the setting of pericardial diseases, it was associated with a lower risk of recurrent pericarditis. In other studies assessing coronary artery disease patients, colchicine was associated with a reduced risk of major adverse cardiovascular events (MACE) such as myocardial infarction, stroke, cardiovascular death, coronary revascularisation and hospitalization.
Among patients with atrial fibrillation, it was associated with lower rates of recurrence. In the single RCT on heart failure, colchicine was not associated with improved NYHA class.
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