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.
Source
West Australian Heart Research Institute, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. smnidorf@amnet.net.au
Abstract
In patients with stable coronary artery disease, elevated levels of biomarkers of inflammation, including high-sensitivity C-reactive protein (hs-CRP) > or = 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 > or = 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 > or = 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 <0 .001=".001" 2.40="2.40" 2.80="2.80" 28="28" 3.65="3.65" 54="54" 60="60" 67="67" a="a" absolute="absolute" an="an" and="and" ci="ci" decrease="decrease" group="group" hs-crp="hs-crp" in="in" mg="mg" of="of" patients="patients" relative="relative" the="the" this="this" to="to" was="was">50% from baseline, and in 31 patients (70%), hs-CRP decreased to <2 .0=".0" additional="additional" advanced="advanced" and="and" are="are" artery="artery" aspirin="aspirin" atorvastatin="atorvastatin" can="can" clinical="clinical" clinically="clinically" colchicine="colchicine" conclusion="conclusion" confirm="confirm" controlled="controlled" coronary="coronary" daily="daily" decrease="decrease" determine="determine" disease.="disease." disease="disease" effectively="effectively" effects="effects" hs-crp="hs-crp" improve="improve" in="in" increased="increased" independent="independent" long-term="long-term" low-dose="low-dose" mg="mg" no="no" observation="observation" of="of" outcomes="outcomes" p="p" patients="patients" reported.="reported." side="side" significant="significant" stable="stable" studies="studies" this="this" to="to" twice="twice" use.="use." use="use" vascular="vascular" warranted="warranted" were="were" whether="whether" with="with">
