Effect of Colchicine (0.5 mg Twice Daily) on High-Sensitivity C-Reactive Protein Independent of Aspirin and Atorvastatin in Patients With Stable Coronary Artery Disease

• Published in: The American journal of cardiology 2007-03, Vol.99 (6), p.805-807
• Main Authors: Nidorf, Mark, MD, Thompson, Peter L., MD
• Format: Article
• Language: English
• Subjects: Aspirin; Aspirin - administration & dosage; Aspirin - therapeutic use; Atorvastatin Calcium; Biological and medical sciences; Biomarkers - blood; C-Reactive Protein - metabolism; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Colchicine - administration & dosage; Colchicine - therapeutic use; Coronary Angiography; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - drug therapy; Coronary Artery Disease - pathology; Coronary heart disease; Drug Administration Schedule; Drug therapy; Female; Heart; Heptanoic Acids - administration & dosage; Heptanoic Acids - therapeutic use; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Male; Medical sciences; Middle Aged; Pilot Projects; Platelet Aggregation Inhibitors - administration & dosage; Platelet Aggregation Inhibitors - therapeutic use; Proteins; Pyrroles - administration & dosage; Pyrroles - therapeutic use; Side effects; Statins; Treatment Outcome
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2006.10.039

In patients with stable coronary artery disease, elevated levels of biomarkers of inflammation, including high-sensitivity C-reactive protein (hs-CRP) ≥2.0 mg/L, are predictors of future vascular events. Because long-term low-dose colchicine is a safe and effective means of dampening inflammation, we conducted an open-label pilot study to determine whether it could significantly lower hs-CRP in patients with stable coronary artery disease in whom hs-CRP was ≥2.0 mg/L despite taking both aspirin and high-dose atorvastatin therapy. Plasma hs-CRP was measured in 200 patients with clinically stable coronary artery disease who were taking aspirin and atorvastatin. In 64 patients, hs-CRP was ≥2.0 mg/L. In 20 of these patients, hs-CRP was measured again at 2 weeks (no treatment group), and in 44 patients, hs-CRP was measured again after 4 weeks of open-label colchicine 0.5 mg twice daily (treatment group). In the no treatment group, mean baseline hs-CRP did not decrease significantly, measuring 4.28 ± 2.03 mg/L at baseline and 3.70 ± 2.30 mg/L after repeated measurement (mean change 11.0%, 95% confidence interval [CI] −30% to +9%, p = NS). In contrast, hs-CRP decreased in all patients administered colchicine, with mean baseline hs-CRP decreasing from 4.58 ± 2.05 to 1.78 ± 1.38 mg/L (p 50% from baseline, and in 31 patients (70%), hs-CRP decreased to