Eur Heart J

Colchicine reduces recurrent vascular events in secondary prevention

June 5, 2025

Study details: This meta-analysis included nine randomized trials with 30,659 patients with prior coronary artery disease or stroke, comparing colchicine vs. no colchicine for secondary prevention. The primary outcome was a composite of CV death, MI, or stroke, analyzed using a fixed-effect inverse variance model.

Results: Colchicine significantly reduced the composite outcome of CV death, MI, or stroke by 12% (relative risk [RR], 0.88; 95% confidence interval, 0.81–0.95; P = 0.002). The risk of MI was reduced by 16% (RR, 0.84; P = 0.016), while reductions in CV death and stroke weren't statistically significant. However, colchicine was associated with a 35% increased risk of hospitalization for GI events (RR, 1.35; P = .004), but no increase in risk of pneumonia, newly diagnosed cancers, or non-cardiovascular death.

Clinical impact: These findings support the use of colchicine as an adjunct for secondary prevention in patients with prior coronary disease or stroke, given its modest but significant reduction in major vascular events and acceptable safety profile, primarily limited by GI intolerance.

Source:

d'Entremont MA, et al. (2025, May 2). Eur Heart J. Colchicine for secondary prevention of vascular events: a meta-analysis of trials. https://pubmed.ncbi.nlm.nih.gov/40314334/