Association of colchicine use with cardiovascular and limb events in peripheral artery disease: Insights from a retrospective cohort study

Background and aims

Colchicine has demonstrated efficacy in treating coronary artery disease, but its efficacy in peripheral artery disease (PAD) remains uncertain. This study aims to address this gap in knowledge.

Methods

A retrospective cohort study was conducted using the TriNetX Network, selecting patients with lower limb PAD between January 1, 2011, and January 1, 2024. Colchicine users were matched 1:1 with non-users through propensity score matching, considering demographics, medical conditions, medications, and psychosocial factors. The primary outcome was a composite of major adverse cardiovascular and limb events (MACLE) - including lower limb amputation, revascularization for lower limb ischemia, acute myocardial infarction, ischemic stroke, and all-cause mortality – over a ten-year follow-up.

Results

From 53,568 colchicine-treated and 1,499,969 untreated patients with lower limb PAD, 52,350 pairs were successfully matched. Over ten years, colchicine was associated with a significant reduction in MACLE (hazard ratio, [HR] 0.90, 95% CI 0.88–0.92, p < 0.001), any lower limb amputation (HR 0.84, 95% CI 0.75–0.94, p = 0.002), revascularization for lower limb ischemia (HR 0.85, 95% CI 0.82–0.88, p < 0.001), major adverse cardiovascular events (HR 0.93, 95% CI 0.91–0.95, p < 0.001), and all-cause mortality (HR 0.90, 95% CI 0.87–0.92, p < 0.001). It also result in a reduced risk of ischemic stroke (HR 0.95, 95% CI 0.92–0.98, p = 0.001), but not of acute myocardial infarction (HR 0.98, 95% CI 0.95–1.01, p = 0.24).

Conclusions

Colchicine significantly reduced major adverse cardiovascular and limb events in patients with lower limb PAD, supporting the need for further investigation.