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Bouleti C, Viscogliosi S, Bresson D, Leboube S, Bochaton T, El-Jonhy N, Amaz C, Prunier F, Bidaux G, Roubille F, Angoulvant D, Mewton N. Colchicine in acute myocardial infarction: cardiovascular events at 1-year follow up. Open Heart 2024; 11:e002474. [PMID: 38233042 PMCID: PMC10806482 DOI: 10.1136/openhrt-2023-002474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/24/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE In the COVERT-MI randomised placebo-controlled trial, oral administration of high-dose colchicine at the time of reperfusion and for 5 days in acute ST-elevated myocardial infarction did not reduce infarct size but was associated with a significant increase in left ventricular thrombus (LVT) in comparison to placebo. We aimed to assess the 1-year clinical outcomes of the study population. METHODS This study is a follow-up analysis of the COVERT-MI study on prespecified secondary clinical endpoints at 1 year. The primary endpoint of this study was a composite of major adverse cardiovascular events (MACEs), including all-cause death, acute coronary syndromes, heart failure events, ischaemic strokes, sustained ventricular arrhythmias and acute kidney injury at 1-year follow-up. The quality of life (QOL) and the drug therapy prescription were also assessed. RESULTS At 1 year, 192 patients (101 patients in the colchicine group, 91 in the placebo group) were followed up. Seventy-six (39.6%) MACEs were reported in the study population. There was no significant difference regarding the number of MACEs between groups: 36 (35.6%) in the colchicine group and 40 (44.1%) in the placebo group (p=0.3). There were no differences in the occurrence of ischaemic strokes between the colchicine group and the control group (3 (3%) vs 2 (2.2%), respectively, p=0.99). There was a trend towards fewer heart failure events in the colchicine group compared with the placebo group (12 (11.9%) vs 18 (19.8%), p=0.20). There was no significant difference in QOL scores at 1 year (75.8±15.7 vs 72.7±16.2 respectively, p=0.18). CONCLUSIONS There was no significant difference between the colchicine and placebo groups at 1 year regarding MACEs, especially concerning deaths or ischaemic strokes. No excess of ischaemic adverse events was observed despite the initial increase in LVT in the colchicine group. TRIAL REGISTRATION NUMBER NCT0315681.
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Affiliation(s)
- Claire Bouleti
- Cardiology, University of Poitiers, Clinical Investigation Center (CIC) INSERM 1402, Poitiers University Hospital, Poitiers, France
| | - Simon Viscogliosi
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
| | - Didier Bresson
- Cardiology, Groupe Hospitalier de la Region de Mulhouse et Sud Alsace, Mulhouse, Grand Est, France
| | - Simon Leboube
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
| | - Thomas Bochaton
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
| | - Naoual El-Jonhy
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
| | - Camille Amaz
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
| | - Fabrice Prunier
- Cardiologie, Université Angers, UPRES EA3860, Laboratoire Cardioprotection, Remodelage et Thrombose, CHU Angers, Angers, France
| | | | - Francois Roubille
- Cardiology, Regional University Hospital Center of Montpellier, Montpellier, France
| | - Denis Angoulvant
- Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Nathan Mewton
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
- IRIS Team, INSERM U1060, Bron, France
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