Drivers of mortality in patients with chronic coronary disease in the low-dose colchicine 2 trial.

Autor: Opstal TSJ; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands. Electronic address: tjerk.opstal@radboudumc.nl., Nidorf SM; Heart and Vascular Research Institute of Western Australia, Perth, Australia; GenesisCare Western Australia, Perth, Australia., Fiolet ATL; Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands; Dutch Network for Cardiovascular Research (WCN), Utrecht, the Netherlands; Department of Cardiology, Meander Medical Centre, Amersfoort, the Netherlands., Eikelboom JW; Department of Medicine, McMaster University, Hamilton, Ontario, Canada., Mosterd A; Dutch Network for Cardiovascular Research (WCN), Utrecht, the Netherlands; Department of Cardiology, Meander Medical Centre, Amersfoort, the Netherlands., Bax WA; Department of Internal Medicine, Northwest Clinics, Alkmaar, the Netherlands., Budgeon CA; University of Western Australia, Perth, Australia., Ronner E; Department of Cardiology, Reinier de Graaf Hospital, Delft, the Netherlands., Prins FJ; Department of Cardiology, Elkerliek Hospital, Helmond, the Netherlands., Tijssen JGP; Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, the Netherlands; Cardialysis BV, Rotterdam, the Netherlands., Schut A; Dutch Network for Cardiovascular Research (WCN), Utrecht, the Netherlands., Thompson PL; Heart and Vascular Research Institute of Western Australia, Perth, Australia; University of Western Australia, Perth, Australia; Sir Charles Gairdner Hospital, Perth, Australia., El Messaoudi S; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands., Cornel JH; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands; Dutch Network for Cardiovascular Research (WCN), Utrecht, the Netherlands.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2023 Feb 01; Vol. 372, pp. 1-5. Date of Electronic Publication: 2022 Dec 15.
DOI: 10.1016/j.ijcard.2022.12.026
Abstrakt: Background: Low-dose colchicine significantly reduces the risk of cardiovascular events in patients with chronic coronary disease. An increase of non-cardiovascular death raised concerns about its safety. This study reports cause-specific mortality and baseline predictors of mortality in the Low-Dose Colchicine 2 (LoDoCo2) trial.
Methods: Patients with chronic coronary disease were randomly allocated to colchicine 0.5 mg once daily or placebo on a background of optimal medical therapy. Cause-specific mortality data were analysed, stratified by treatment status. Multivariate analyses were performed to examine the predictors of mortality as well as cardiovascular and non-cardiovascular death.
Results: After a median 28.6 months follow-up, 133 out of 5522 participants (2.4%) died. Forty-five deaths were cardiovascular (colchicine versus placebo: 20 [0.7%] versus 25 [0.9%], HR, 0.80; 95% CI, 0.44-1.44), while eighty-eight deaths were non-cardiovascular (53 [1.9%] versus 35 [1.3%]; HR, 1.51; 95% CI, 0.99-2.31). Forty-eight deaths were due to cancer (26 [0.9%] versus 22 [0.8%]), thirteen end-stage pulmonary disease (9 [0.3%] versus 4 [0.1%]), eight infection (4 [0.1%] versus 4 [0.1%]), five dementia (4 [0.1%] versus 1 [0.0%]) and five related multiple organ failure (3 [0.1%] versus 2 [0.1%]). Multivariable analysis demonstrated age > 65 years was the only independent baseline characteristic associated with non-cardiovascular death (HR, 3.65; 95% CI, 2.06-6.47).
Conclusions: During the LoDoCo2 trial, assignment to colchicine was not associated with an adverse effect on any specific causes of death. Most deaths were related to non-cardiovascular causes, underscoring the importance of comorbidities as drivers of all-cause mortality in patients with chronic coronary disease.
Competing Interests: Declaration of Competing Interest The authors report no relationships that could be construed as a conflict of interest.
(Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: