Colchicine in Coronary Artery Disease: A Contemporary Review of Evidence from Clinical Outcomes and Imaging Trials.

Abstract

Colchicine treats a wide array of autoimmune and inflammatory conditions by inhibiting the NOD-like receptor protein 3 (NLRP3) inflammasome and key pro-inflammatory cytokines. In recent years, it has gained ground as an attenuator of vascular inflammation and a driver of atherosclerosis and cardiovascular disease (CVD). The recent Food and Drug Administration (FDA) approval of colchicine for cardiovascular risk reduction heralds a new era of its use in coronary artery disease (CAD). This paper reviews the evidence from completed and ongoing clinical trials on the therapeutic impact of colchicine on major adverse cardiovascular events (MACE) and atherosclerotic burden, including its mechanism of action on inflammatory pathways and cellular processes. We examine outcome trials on cardiovascular event reduction and novel imaging studies assessing atherosclerosis progression. In conclusion, this analysis aims to provide clinicians with a clearer understanding of the role of colchicine in cardiovascular health, including its potential therapeutic indications and limitations.