Low-Dose Colchicine for Secondary Prevention in Patients With Chronic Coronary Syndrome: A Multicenter Real-World Study

Aims

Chronic coronary syndrome (CCS) remains associated with recurrent ischemic symptoms and impaired quality of life despite contemporary guideline-directed medical therapy. Low-dose colchicine has demonstrated prognostic benefits in randomized trials; however, real-world data regarding its effects on functional capacity and angina-related outcomes are limited.

Methods

This multicenter, real-world observational study included 614 patients with CCS receiving low-dose colchicine therapy for secondary prevention. Functional capacity and angina-related quality of life were assessed before and after colchicine treatment using the Seattle Angina Questionnaire. Changes in daily physical activities, angina frequency, nitroglycerin use, treatment satisfaction, and Canadian Cardiovascular Society (CCS) angina class were evaluated. Clinical outcomes and tolerability, including hospitalization, revascularization, and gastrointestinal adverse effects, were also analyzed. A clinically meaningful improvement was defined as a ≥ 10-point increase in the composite Seattle Angina Questionnaire score.

Results

The mean age of the study population was 68.8 ± 11.5 years, and 70.5% of patients were male. Following colchicine therapy, significant improvements were observed in functional capacity, including walking on level ground, household activities, and carrying heavy objects (all p < 0.001). Angina frequency scores improved, accompanied by reduced nitroglycerin use (p < 0.001). Treatment satisfaction increased and limitations in enjoyment of life decreased significantly (p < 0.001). CCS angina class decreased from 2.61 ± 0.7 to 1.4 ± 0.62 (p < 0.001). A clinically meaningful improvement in SAQ score was observed in 78.7% of patients. During follow-up, hospitalization occurred in 9.0% of patients, revascularization in 4.4%, and gastrointestinal adverse effects were reported in 9.4%.

Conclusions

In a multicenter real-world cohort of patients with chronic coronary syndrome, low-dose colchicine therapy was associated with significant improvements in functional capacity, angina severity, and quality of life, with an acceptable safety profile. The high rate of clinically meaningful patient-reported improvement further supports colchicine as an effective adjunctive therapy for secondary prevention and symptom control in routine clinical practice.