Efficacy of low dose colchicine on left ventricular hypertrophy in patients with coronary artery disease: A randomized controlled trial

Abstract

Background: Left ventricular hypertrophy (LVH) contributes to a substantial risk of adverse outcomes in patients with coronary artery disease (CAD). Inflammation is one of the mechanisms responsible for LVH progression. The study aimed to test the efficacy of colchicine, an anti-inflammatory agent, to reduce left ventricular mass in patients with CAD and LVH. Methods: Sixty-six patients with CAD, LVH and controlled blood pressure were randomly assigned to colchicine 0.6 mg daily or placebo for 48 weeks after a run-in period. The primary endpoint was changes in left ventricular mass index (LVMI) measured by cardiac magnetic resonance imaging. Results: After 48 weeks of treatment, the change in LVMI in the colchicine group was −0.71 g/m² (interquartile range −6.51, 2.31) while it was −1.28 g/m² (interquartile range −5.61, 5.50) in the placebo group. The absolute difference in the LVMI changes between the two groups was 0.57 g/m2 (95% confidence interval −5.61 to 4.1) with adjusted p value of 0.66. No significant differences in changes in left ventricular volume, left atrial volume, high-sensitivity C-reactive protein, insulin levels, haemoglobin A1c or body mass index were observed between the two groups. Conclusion: The study failed to demonstrate a treatment benefit of colchicine over placebo regarding LVMI reduction at 48 weeks. Given the early termination of the study, the results are inconclusive as the study was underpowered to detect small but potentially clinically meaningful differences.