Coronary disease & ACSDiagnostic or prognostic study
Individual lifetime benefit from low-dose colchicine in patients with chronic coronary artery disease
- Modelling study of individual lifetime treatment benefit
- SMART-REACH model
- LoDoCo2 trial and UCC-SMART cohort
- external validation in REduction of Atherothrombosis for Continued Health (REACH) registry
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 studyREACH 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
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 |
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 |
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:10.1093/eurjpc/zwad221
Summarised from the published abstract; every number is checked against it