Can colchicine prevent acute myocardial infarction? Systematic review and meta-analysis

Introduction and objectives: The association between the use of colchicine and the incidence of acute myocardial infarction(AMI) is inconsistent. The main objective of this study was to evaluate the effect of colchicine on the incidence of AMI. Assessmentof the incidence of stroke and cardiovascular mortality were secondary endpoints.Methods: A meta-analysis of randomized studies that evaluated the use of colchicine in patients with atherosclerotic diseaseand reported cardiovascular events was performed, after searching the PubMed/MEDLINE, Embase, Scielo and CochraneControlled Trials databases. A fixed or random effects model were used depending on the heterogeneity observed.Results: Seven studies were selected for the analysis of the primary end point (5966 subjects in the colchicine arm and 5948patients in the control arm). This meta-analysis demonstrated that colchicine therapy was associated with a lower risk of AMI(OR: 0.76, 95% CI: 0.62-0.92; I2 = 15%). Likewise, a significant reduction in the incidence of stroke was observed without asignificant effect on cardiovascular mortality with pharmacological intervention.Conclusion: The use of colchicine in patients with atherosclerotic cardiovascular disease was associated with a significant reductionin the incidence of AMI. The incorporation of colchicine into the therapeutic arsenal of cardiovascular disease shouldbe considered by future clinical practice guidelines.