Effects of Acute Colchicine Administration Prior to Percutaneous Coronary Intervention: COLCHICINE-PCI Randomized Trial
| Autor: | Stuart D. Katz, Jeffrey D. Lorin, Binita Shah, Yuhe Xia, Bruce N. Cronstein, Hua Zhong, Michael H. Pillinger, Nicole Ratnapala, Frederick Feit, Norma Keller, Nathaniel R. Smilowitz |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Anti-Inflammatory Agents Administration Oral Inflammation Coronary Artery Disease 030204 cardiovascular system & hematology Drug Administration Schedule law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Percutaneous Coronary Intervention Randomized controlled trial Double-Blind Method law Risk Factors Internal medicine medicine Colchicine Humans 030212 general & internal medicine Myocardial infarction Prospective Studies Acute Coronary Syndrome Aged business.industry Interleukin-6 Percutaneous coronary intervention Middle Aged medicine.disease Increased risk C-Reactive Protein Treatment Outcome chemistry Conventional PCI Biomarker (medicine) Female New York City Stents medicine.symptom Inflammation Mediators Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | Circulation. Cardiovascular interventions. 13(4) |
| ISSN: | 1941-7632 |
| Popis: | Background: Vascular injury and inflammation during percutaneous coronary intervention (PCI) are associated with increased risk of post-PCI adverse outcomes. Colchicine decreases neutrophil recruitment to sites of vascular injury. The anti-inflammatory effects of acute colchicine administration before PCI on subsequent myocardial injury are unknown. Methods: In a prospective, single-site trial, subjects referred for possible PCI (n=714) were randomized to acute preprocedural oral administration of colchicine 1.8 mg or placebo. Results: Among the 400 subjects who underwent PCI, the primary outcome of PCI-related myocardial injury did not differ between colchicine (n=206) and placebo (n=194) groups (57.3% versus 64.2%, P =0.19). The composite outcome of death, nonfatal myocardial infarction, and target vessel revascularization at 30 days (11.7% versus 12.9%, P =0.82), and the outcome of PCI-related myocardial infarction defined by the Society for Cardiovascular Angiography and Interventions (2.9% versus 4.7%, P =0.49) did not differ between colchicine and placebo groups. Among 280 PCI subjects in a nested inflammatory biomarker substudy, the primary biomarker end point, change in interleukin-6 concentrations did not differ between groups 1-hour post-PCI but increased less 24 hours post-PCI in the colchicine (n=141) versus placebo group (n=139; 76% [−6 to 898] versus 338% [27 to 1264], P =0.02). High-sensitivity C-reactive protein concentration also increased less after 24 hours in the colchicine versus placebo groups (11% [−14 to 80] versus 66% [1 to 172], P =0.001). Conclusions: Acute preprocedural administration of colchicine attenuated the increase in interleukin-6 and high-sensitivity C-reactive protein concentrations after PCI when compared with placebo but did not lower the risk of PCI-related myocardial injury. Registration: URL: https://www.clinicaltrials.gov ; Unique Identifiers: NCT02594111, NCT01709981. |
| Databáze: | OpenAIRE |
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