Individual lifetime benefit from low-dose colchicine in patients with chronic coronary artery disease
Authors' conclusion
The absolute benefits of low-dose colchicine vary between individual patients with chronic CAD. They may be expected to be of at least similar magnitude to those of intensified LDL-c and SBP reduction in a majority of patients already on conventional lipid-lowering and blood pressure-lowering therapy.
Study context
- Population
- Patients with chronic coronary artery disease (CAD) from the LoDoCo2 trial and UCC-SMART studyREduction of Atherothrombosis for Continued Health (REACH) validation n = 25,812
- Participants
- 10,830 patients
- Comparison
- Low-dose colchicine vs intensified LDL-c reduction vs systolic blood pressure (SBP) reduction
- Outcome
- Individual 10-year ARR for MACE (MI, stroke or CV death) and MACE-free life-years gained
- Follow-up
- 10 years; lifetime
Methodological detailsSMART-REACH model, LoDoCo2 trial and UCC-SMART cohort, external validation in REACH registry
- SMART-REACH model
- LoDoCo2 trial and UCC-SMART cohort
- External validation in REACH registry
Performance
As reported in the abstract
MACE
| Test or model | Value | MACE-free years gained (IQR 1.6-2.5) | MACE-free life-years gained (IQR 0.6-2.1) | MACE-free life-years gained (IQR 0.0-2.3) |
|---|---|---|---|---|
| Low-dose colchicine | median 10-year ARR 4.6% (IQR 3.6–6.0%) | 2.0 | ||
| LDL-c reduction | median 10-year ARR 3.0% (IQR 1.5–5.1%) | 1.2 | ||
| SBP reduction | median 10-year ARR 1.7% (IQR 0.0–5.7%) | 0.7 |
Value
Low-dose colchicinemedian 10-year ARR 4.6% (IQR 3.6–6.0%)
LDL-c reductionmedian 10-year ARR 3.0% (IQR 1.5–5.1%)
SBP reductionmedian 10-year ARR 1.7% (IQR 0.0–5.7%)
MACE-free years gained (IQR 1.6-2.5)
Low-dose colchicine2.0
LDL-c reductionNot reported in the abstract
SBP reductionNot reported in the abstract
MACE-free life-years gained (IQR 0.6-2.1)
Low-dose colchicineNot reported in the abstract
LDL-c reduction1.2
SBP reductionNot reported in the abstract
MACE-free life-years gained (IQR 0.0-2.3)
Low-dose colchicineNot reported in the abstract
LDL-c reductionNot reported in the abstract
SBP reduction0.7
Further findings
| Outcome | Low-dose colchicine | LDL-c reduction | SBP reduction | |
|---|---|---|---|---|
| MACE+ (MACE plus coronary revascularization) | median 10-year ARR 8.6% (IQR 7.6–9.8%) | |||
| MACE+-free life-years gained (IQR 2.6-4.2) | 3.4 | Not reported in the abstract | Not reported in the abstract | LDL-c reduction, SBP reduction: not reported in the abstract |
MACE+ (MACE plus coronary revascularization)
- Similar results for MACE+ and in American and European patients from REACH
Original publication
Individual lifetime benefit from low-dose colchicine in patients with chronic coronary artery disease. Eur J Prev Cardiol. Published 6 July 2023. doi:10.
Summarised from the published abstract; every number is checked against it