Effect of colchicine on reducing C-reactive protein levels among patients with acute coronary syndrome: a meta-analysis

Abstract Background Patients who have undergone Acute Coronary syndrome (ACS), whether ST segment or Non ST Segment elevated myocardial infarction, are more prone to have increased inflammation, as measured by C-reactive protein (CRP). Persistence of this inflammation may lead to future plaque instability and recurrence of ACS. Colchicine is known to have anti-inflammatory properties that aid in lowering ACS recurrence. This meta-analysis aims to investigate the current data for colchicine and its efficacy in reducing markers of acute inflammation such as CRP in the setting of patients with ACS. Methods The four studies considered for this meta-analysis were randomized control trials published from 2012 to 2016 that included patients who had ACS and were given Colchicine as an adjunctive therapy compared to placebo. The primary outcome investigated was CRP levels during hospital admission and 30 days after administration of colchicine. Results The pooled evidence showed that there is no heterogeneity among the studies I-squared = 0%. These studies, which compared 264 patients on colchicine and 277 patients on placebo, showed a decrease in CRP values after taking colchicine (p=0.97, Mean Difference −0.03, 95% CI [−1.94, 1.88]). This decrease, however, was not statistically significant. Conclusion Colchicine has no statistically significant evidence in reducing CRP levels in patients with ACS. Therefore, the use of colchicine routinely in ACS, particularly for the reduction of CRP, may not be warranted given the current level of evidence Funding Acknowledgement Type of funding sources: None.