Aernoud Fiolet

364 Chapter 15 Identifying the right patient Firstly, when identifying the “right” patient, the Reynolds risk score and the Secondary Manifestations of ARTerial disease (SMART) risk score demonstrated the additional prognostic value of using high-sensitivity C – Reactive protein (hsCRP) in risk stratification, but have not yet resulted in inclusion in clinical recommendation in European guidelines. 10,11 Clinical risk calculators, such as U-Prevent.com may help to estimate the individual benefit for individual patients based on clinical parameters. The clinical evidence for colchicine was accrued in an “all-comer” population of coronary disease without preselection for inflammatory biomarkers. Multiple ongoing clinical studies are focused on short- and long-term colchicine treatment in particular subpopulations. ( Figure 2 and Table 2) � � � � � � � � � � � � � � � � � � � � � � � � � � � � LoDoCo Deftereos LoDoCo2 COLCOT COPS CONVINCE CLEAR−Synergy COLCARDIO COP−AF COVERT−MI COCS IMPROVE−PVI Pilot CADENCE COLICA 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Including cardiovascular or all−cause mortality as end point Colchicine randomised clinical trials Figure 2. Randomised clinical trials of colchicine. Registered on ClincialTrials.gov as either not yet recruiting, enrolling, or enrolling by invitation with >100 targeted enrolment and including cardiovascular or all-cause mortality as end points. Accessed August 18 th , 2021 (dashed line). Studies in dark blue represent long-term use, studies in light blue represent short-term use (≤90 days). We have shown in Chapter 8 that patients remain at a high risk of new ischemic events, even years after the last acute coronary syndrome. The ongoing Colchicine Cardiovascular Outcomes in Acute Coronary Syndrome trial (COLCARDIO-