Aernoud Fiolet

175 The efficacy and safety of low-dose colchicine in patients with coronary disease VISUAL ABSTRACT Myocardial infarction Colchicine in Coronary Disease RR 0.78 (95% CI 0.64 to 0.94) RR 0.54 (95% CI 0.34 to 0.86) RR 0.77 (95% CI 0.66 to 0.90) A meta-analysis of 5 studies Colchicine 0.5 mg 4.2% 250/5806 Pooled relative risk reduction 25% (RR 0.75, 95% CI 0.61 to 0.92) MACE Myocardial infarction, stroke, or cardiovascular death Placebo or no colchicine 5.7% 328/5788 RR 0.82 (95% CI 0.55 to 1.23) No significant relative risk reduction Inflammasome Caspase-1 Pro-IL-1β IL-1β 1 Inhibiting inflammasome activation 2 Inhibiting neutrophil chemotaxis, adhesion and activation 3 Inhibiting neutrophil-platelet interaction Crytalloids Potential mechanisms Stroke Coronary revascularisation Cardiovascular death Significant relative risk reduction Significant relative risk reduction Significant relative risk reduction 22% 46% 23% INTRODUCTION D espite improvements in prevention, the global burden of cardiovascular disease continues to rise. 1 Guidelines recommend lifestyle changes (exercise, nutrition, smoking cessation), control of risk factors (hypertension, dyslipidaemia, dysglycaemia), andanti-thrombotic therapy inpatientswithcoronarydisease, 2–4 but even when these are routinely adopted, a high residual risk remains of myocardial infarction, stroke, coronary revascularization, or cardiovascular death. 5,6