Colchicine for secondary prevention of vascular events: a meta-analysis of trials

Marc-André d'Entremont; Michiel H F Poorthuis; Aernoud T L Fiolet; Pierre Amarenco; Kevin Emery Boczar; Ian Buysschaert; Noel C Chan; Jan H Cornel; Jalina Jannink; Shirley Jansen; Sasko Kedev; Anthony C Keech; Jamie Layland; Nathan Mewton; Gilles Montalescot; Domingo A Pascual-Figal; Alfredo E Rodriguez; Binita Shah; Martin Teraa; Aimee van Zelm; Yongjun Wang; Arend Mosterd; Peter Kelly; John Eikelboom; Sanjit S Jolly

doi:10.1093/eurheartj/ehaf210

Colchicine for secondary prevention of vascular events: a meta-analysis of trials

Marc-André d'Entremont
, Michiel H F Poorthuis
, Aernoud T L Fiolet
, Pierre Amarenco
, Kevin Emery Boczar
, Ian Buysschaert
, Noel C Chan
, Jan H Cornel
, Jalina Jannink
, Shirley Jansen
, Sasko Kedev
, Anthony C Keech
, Jamie Layland
, Nathan Mewton
, Gilles Montalescot
, Domingo A Pascual-Figal
, Alfredo E Rodriguez
, Binita Shah
, Martin Teraa
, Aimee van Zelm

Yongjun Wang, Arend Mosterd, Peter Kelly, John Eikelboom, Sanjit S Jolly^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND AND AIMS: Randomized trials of colchicine in secondary prevention of atherosclerotic cardiovascular disease have shown mixed results.

METHODS: A systematic review and study-level meta-analysis of randomized controlled trials was performed comparing colchicine vs no colchicine in a secondary-prevention atherosclerotic cardiovascular disease population. A fixed-effect inverse variance model was applied using the intention-to-treat population from the included trials. The primary outcome was the composite of cardiovascular death, myocardial infarction, or stroke.

RESULTS: Nine trials, including 30 659 patients (colchicine 15 255, no colchicine 15 404) with known coronary artery disease or stroke, were included. Compared with no colchicine, patients randomized to colchicine had a relative risk (RR) of 0.88 [95% confidence interval (CI) 0.81-0.95, P = .002] for the primary composite outcome, including a RR of 0.94 for cardiovascular death (95% CI 0.78-1.13, P = .5), a RR of 0.84 for myocardial infarction (95% CI 0.73-0.97, P = .016), and a RR of 0.90 for stroke (95% CI 0.80-1.02, P = .09). Colchicine was associated with a RR of 1.35 for hospitalization for gastrointestinal events (95% CI 1.10-1.66, P = .004) with no increase in hospitalization for pneumonia, newly diagnosed cancers, or non-cardiovascular death.

CONCLUSIONS: In patients with prior coronary disease or stroke, colchicine reduced the composite of cardiovascular death, myocardial infarction, or stroke by 12%.

Original language	English
Pages (from-to)	2564–2575
Number of pages	12
Journal	European heart journal
Volume	46
Issue number	26
Early online date	2 May 2025
DOIs	https://doi.org/10.1093/eurheartj/ehaf210
Publication status	Published - Jul 2025

Keywords

Colchicine
Coronary revascularization
Inflammation
Myocardial infarction
Stroke

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10.1093/eurheartj/ehaf210

ehaf210Final published version, 1.5 MBLicence: Taverne

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d'Entremont, M.-A., Poorthuis, M. H. F., Fiolet, A. T. L., Amarenco, P., Boczar, K. E., Buysschaert, I., Chan, N. C., Cornel, J. H., Jannink, J., Jansen, S., Kedev, S., Keech, A. C., Layland, J., Mewton, N., Montalescot, G., Pascual-Figal, D. A., Rodriguez, A. E., Shah, B., Teraa, M., ... Jolly, S. S. (2025). Colchicine for secondary prevention of vascular events: a meta-analysis of trials. European heart journal, 46(26), 2564–2575. https://doi.org/10.1093/eurheartj/ehaf210

@article{6e684b574a5d4f479142689a1fb29a04,

title = "Colchicine for secondary prevention of vascular events: a meta-analysis of trials",

abstract = "BACKGROUND AND AIMS: Randomized trials of colchicine in secondary prevention of atherosclerotic cardiovascular disease have shown mixed results.METHODS: A systematic review and study-level meta-analysis of randomized controlled trials was performed comparing colchicine vs no colchicine in a secondary-prevention atherosclerotic cardiovascular disease population. A fixed-effect inverse variance model was applied using the intention-to-treat population from the included trials. The primary outcome was the composite of cardiovascular death, myocardial infarction, or stroke.RESULTS: Nine trials, including 30 659 patients (colchicine 15 255, no colchicine 15 404) with known coronary artery disease or stroke, were included. Compared with no colchicine, patients randomized to colchicine had a relative risk (RR) of 0.88 [95\% confidence interval (CI) 0.81-0.95, P = .002] for the primary composite outcome, including a RR of 0.94 for cardiovascular death (95\% CI 0.78-1.13, P = .5), a RR of 0.84 for myocardial infarction (95\% CI 0.73-0.97, P = .016), and a RR of 0.90 for stroke (95\% CI 0.80-1.02, P = .09). Colchicine was associated with a RR of 1.35 for hospitalization for gastrointestinal events (95\% CI 1.10-1.66, P = .004) with no increase in hospitalization for pneumonia, newly diagnosed cancers, or non-cardiovascular death.CONCLUSIONS: In patients with prior coronary disease or stroke, colchicine reduced the composite of cardiovascular death, myocardial infarction, or stroke by 12\%.",

keywords = "Colchicine, Coronary revascularization, Inflammation, Myocardial infarction, Stroke",

author = "Marc-Andr{\'e} d'Entremont and Poorthuis, \{Michiel H F\} and Fiolet, \{Aernoud T L\} and Pierre Amarenco and Boczar, \{Kevin Emery\} and Ian Buysschaert and Chan, \{Noel C\} and Cornel, \{Jan H\} and Jalina Jannink and Shirley Jansen and Sasko Kedev and Keech, \{Anthony C\} and Jamie Layland and Nathan Mewton and Gilles Montalescot and Pascual-Figal, \{Domingo A\} and Rodriguez, \{Alfredo E\} and Binita Shah and Martin Teraa and \{van Zelm\}, Aimee and Yongjun Wang and Arend Mosterd and Peter Kelly and John Eikelboom and Jolly, \{Sanjit S\}",

year = "2025",

month = jul,

doi = "10.1093/eurheartj/ehaf210",

language = "English",

volume = "46",

pages = "2564–2575",

journal = "European heart journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "26",

}

d'Entremont, M-A, Poorthuis, MHF, Fiolet, ATL, Amarenco, P, Boczar, KE, Buysschaert, I, Chan, NC, Cornel, JH, Jannink, J, Jansen, S, Kedev, S, Keech, AC, Layland, J, Mewton, N, Montalescot, G, Pascual-Figal, DA, Rodriguez, AE, Shah, B, Teraa, M, van Zelm, A, Wang, Y, Mosterd, A, Kelly, P, Eikelboom, J & Jolly, SS 2025, 'Colchicine for secondary prevention of vascular events: a meta-analysis of trials', European heart journal, vol. 46, no. 26, pp. 2564–2575. https://doi.org/10.1093/eurheartj/ehaf210

TY - JOUR

T1 - Colchicine for secondary prevention of vascular events

T2 - a meta-analysis of trials

AU - d'Entremont, Marc-André

AU - Poorthuis, Michiel H F

AU - Fiolet, Aernoud T L

AU - Amarenco, Pierre

AU - Boczar, Kevin Emery

AU - Buysschaert, Ian

AU - Chan, Noel C

AU - Cornel, Jan H

AU - Jannink, Jalina

AU - Jansen, Shirley

AU - Kedev, Sasko

AU - Keech, Anthony C

AU - Layland, Jamie

AU - Mewton, Nathan

AU - Montalescot, Gilles

AU - Pascual-Figal, Domingo A

AU - Rodriguez, Alfredo E

AU - Shah, Binita

AU - Teraa, Martin

AU - van Zelm, Aimee

AU - Wang, Yongjun

AU - Mosterd, Arend

AU - Kelly, Peter

AU - Eikelboom, John

AU - Jolly, Sanjit S

PY - 2025/7

Y1 - 2025/7

N2 - BACKGROUND AND AIMS: Randomized trials of colchicine in secondary prevention of atherosclerotic cardiovascular disease have shown mixed results.METHODS: A systematic review and study-level meta-analysis of randomized controlled trials was performed comparing colchicine vs no colchicine in a secondary-prevention atherosclerotic cardiovascular disease population. A fixed-effect inverse variance model was applied using the intention-to-treat population from the included trials. The primary outcome was the composite of cardiovascular death, myocardial infarction, or stroke.RESULTS: Nine trials, including 30 659 patients (colchicine 15 255, no colchicine 15 404) with known coronary artery disease or stroke, were included. Compared with no colchicine, patients randomized to colchicine had a relative risk (RR) of 0.88 [95% confidence interval (CI) 0.81-0.95, P = .002] for the primary composite outcome, including a RR of 0.94 for cardiovascular death (95% CI 0.78-1.13, P = .5), a RR of 0.84 for myocardial infarction (95% CI 0.73-0.97, P = .016), and a RR of 0.90 for stroke (95% CI 0.80-1.02, P = .09). Colchicine was associated with a RR of 1.35 for hospitalization for gastrointestinal events (95% CI 1.10-1.66, P = .004) with no increase in hospitalization for pneumonia, newly diagnosed cancers, or non-cardiovascular death.CONCLUSIONS: In patients with prior coronary disease or stroke, colchicine reduced the composite of cardiovascular death, myocardial infarction, or stroke by 12%.

AB - BACKGROUND AND AIMS: Randomized trials of colchicine in secondary prevention of atherosclerotic cardiovascular disease have shown mixed results.METHODS: A systematic review and study-level meta-analysis of randomized controlled trials was performed comparing colchicine vs no colchicine in a secondary-prevention atherosclerotic cardiovascular disease population. A fixed-effect inverse variance model was applied using the intention-to-treat population from the included trials. The primary outcome was the composite of cardiovascular death, myocardial infarction, or stroke.RESULTS: Nine trials, including 30 659 patients (colchicine 15 255, no colchicine 15 404) with known coronary artery disease or stroke, were included. Compared with no colchicine, patients randomized to colchicine had a relative risk (RR) of 0.88 [95% confidence interval (CI) 0.81-0.95, P = .002] for the primary composite outcome, including a RR of 0.94 for cardiovascular death (95% CI 0.78-1.13, P = .5), a RR of 0.84 for myocardial infarction (95% CI 0.73-0.97, P = .016), and a RR of 0.90 for stroke (95% CI 0.80-1.02, P = .09). Colchicine was associated with a RR of 1.35 for hospitalization for gastrointestinal events (95% CI 1.10-1.66, P = .004) with no increase in hospitalization for pneumonia, newly diagnosed cancers, or non-cardiovascular death.CONCLUSIONS: In patients with prior coronary disease or stroke, colchicine reduced the composite of cardiovascular death, myocardial infarction, or stroke by 12%.

KW - Colchicine

KW - Coronary revascularization

KW - Inflammation

KW - Myocardial infarction

KW - Stroke

UR - https://www.scopus.com/pages/publications/105010746816

U2 - 10.1093/eurheartj/ehaf210

DO - 10.1093/eurheartj/ehaf210

M3 - Article

C2 - 40314334

SN - 0195-668X

VL - 46

SP - 2564

EP - 2575

JO - European heart journal

JF - European heart journal

IS - 26

ER -

Colchicine for secondary prevention of vascular events: a meta-analysis of trials

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