Aernoud Fiolet

221 Colchicine in chronic coronary disease in relation to history of acute coronary syndrome frequently treated with coronary artery bypass grafting. The majority of patients were receiving guideline recommended secondary prevention therapies, including in the patients of the very remote ACS subgroup, with over 90% treated with lipid lowering agents, and less than 1% receiving no antiplatelet agent or anticoagulant. Prior ACS status and major adverse cardiovascular events In both unadjusted and adjusted analyses, we found no difference in the incidence of the composite of cardiovascular death, spontaneous myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization between patients with prior ACS compared to patients with no prior ACS. Patients with remote ACS had a similar risk of the primary end point compared to patients with recent ACS, and patients with very remote ACS had a slightly higher incidence of the primary end point compared to patients with recent ACS, although this difference was not significant after adjustment for confounders (Table 2, Supplemental Table S2). Colchicine efficacy in subgroups according to prior ACS status The effects of colchicine compared to placebo on the risk of the composite of cardiovascular death, spontaneous myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization were consistent in patients with no prior ACS (incidence: 2.8 vs. 3.4 events per 100 person-years; HR: 0.81; 95% CI: 0.52 to 1.27) and in those with prior ACS (incidence: 2.4 vs. 3.6 events per 100 person-years; HR: 0.67; 95% CI 0.54 to 0.82; p-value for interaction = 0.43). The reduction of the primary end point by colchicine compared to placebo was also consistent across the subgroups of patients with prior ACS: recent ACS (incidence: 2.4 vs. 3.3 events per 100 person-years; HR: 0.75; 95% CI: 0.51 to 1.10), remote ACS (incidence: 1.8 vs. 3.2 events per 100 person-years; HR: 0.55; 95% CI: 0.37 to 0.82), and very remote ACS (incidence: 3.0 vs. 4.3 events per 100 person-years; HR: 0.70; 95% CI: 0.51 to 0.96; p-value for interaction = 0.59) (Central Illustration, Figure 1 and Figure 2).