Colchicine treatment following acute coronary syndrome (ACS) leads to a greater chance of improvement in physical limitation scores, however it did not seem to affect health status at 1-year follow-up. These findings were published in Cardiovascular Revascularization Medicine.
Researchers investigated whether colchicine affects health status outcomes among patients presenting with ACS. Using data from the Australian COPS trial, a randomized placebo-controlled, double-blind trial comparing colchicine vs placebo that included 795 patients with ACS and at least 12 months of follow-up, the researchers conducted a symptom-based survey. The COPS trial showed that colchicine did not reduce the 12-month primary endpoint, which was a composite of all-cause mortality, ACS, ischemia-driven unplanned urgent revascularization, and noncardioembolic ischemic stroke, but was associated with an increased rate of noncardiac mortality.
In the survey, researchers used the Euro-Qol-5 Dimension 5-level (EQ-5D-5L) score and the Seattle Angina Questionnaire (SAQ) to assess health status at baseline and 12 months for 786 of the patients. These patients had been randomly assigned to the colchicine group (n=388) and the placebo group (n=398).
Baseline characteristics were matched between the colchicine and placebo groups (mean age 60.1±14.8 years, 20% women), and included patients who currently smoke (33.6% vs 38.1%, respectively), have a body mass index of 30 or greater (28.9% vs 25.6%), have family history of ACS (44.8% vs 35.9%), history of stroke (1.3% vs 2.8%), and presented with STEMI (47.7% vs 52.8%). Researchers noted that baseline health status scores were impaired and there was significant improvement in most parameters at 12-months (EQ-5D-5L Visual Analogue Score, 69.3-77.7; SAQ angina frequency score 83.0-95.3; both P <.001). They observed no change between treatment groups in adjusted mean score in any of the SAQ or EQ-5D-5L stratifications.
Borderline interactions were noted in EQ-5D-5L scores among patients with previous myocardial infarction and in SAQ scores among patients with obesity.
Researchers said the colchicine group was more likely to have clinically significant improvement in physical limitation score through 12 months vs placebo (36% vs 28%; P <.05). They reported the following data on SAQ physical limitation scores:
- At baseline: colchicine 73.4±1.02, placebo 75.0±1.05.
- At 12 months: colchicine 72.5±1.09, placebo 71.6±1.03.
- Mean change from baseline to 12 months: colchicine -0.96, placebo -3.4; difference between groups 2.4.
- P-value for the change with colchicine was .50, 0.012 for placebo, and 0.20 for the difference between the 2 groups.
Researchers said the primary endpoint at 12 months had not been associated with baseline health status scores.
Study limitations include the short 12-month follow-up and the underpowered sample size. There also was residual bias resulting from there being approximately 11% of patients with no QOL follow-up data at 12-months.
“Treatment with colchicine did not appear to affect change in measures of health status following acute coronary syndromes, but it did lead to a greater likelihood of improvement in physical limitation scores,” the study authors wrote.
Dawson LP, Quinn S, Tong D, et al. Colchicine and quality of life in patients with acute coronary syndromes: results from the COPS randomized trial. Cardiovasc Revasc Med. Published online June 18, 2022. doi:10.1016/j.carrev.2022.06.017