Colchicine in acute coronary syndromes: a systematic review and meta-analysis of randomised controlled trials
Authors' conclusion
Low-dose colchicine may reduce recurrent ischaemic events in ACS, but evidence remains uncertain due to heterogeneity and limited long-term data. Safety and efficacy in women and optimal dosing require further investigation.
Study context
- Population
- Patients with acute coronary syndrome (ACS) in randomised controlled trials (RCTs) comparing colchicine versus placeboSeventeen RCTs, 7390 (50%) randomised to colchicine
- Participants
- 14,794 patients
- Comparison
- Colchicine versus placebo in ACS
- Colchicinen = 7,390
- Outcome
- adverse cardiovascular events (ACEs), mortality and safety
- Follow-up
- Ranging from 5 days to 12 months
Methodological detailsrandomised controlled trials, random-effects models
- Randomised controlled trials
- Random-effects models
Pooled result
As reported in the abstract
colchicine vs placeboRelative risk (95% CI)P value
All-cause mortality; I²=12%
0.95(0.79–1.14)
Cardiovascular death; I²=0%
1.03(0.82–1.30)
ACE; I²=58%
0.77(0.59–1.01)
P = 0.05Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Recurrent ACSI²=55% | 0.41 (0.19–0.92) | P = 0.03 | |
| Unstable anginaI²=0% | 0.27 (0.11–0.63) | P < 0.01 | |
| ACE with colchicine 0.5 mg/day (subgroup)I²=41% · subgroup analysis | 0.63 (0.45–0.88) | ||
| 0.10.31310Relative risk (log scale) |
ACE with colchicine 0.5 mg/day (subgroup)
- Subgroup analyses suggested a dose-dependent effect; higher doses increasing gastrointestinal symptoms
Original publication
Colchicine in acute coronary syndromes: a systematic review and meta-analysis of randomised controlled trials. Heart. Published 16 May 2025. doi:10.
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