Colchicine in Secondary Prevention — EECC MCQ
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Correct answer: E — Low-dose colchicine (0.5 mg daily) reduced cardiovascular events in patients with stable CAD, supporting an anti-inflammatory strategy for secondary prevention
The COLCOT trial (post-MI within 30 days) and LoDoCo2 trial (chronic coronary syndrome) independently demonstrated that low-dose colchicine 0.5 mg daily significantly reduces cardiovascular events (composite of CV death, MI, stroke, urgent revascularisation) by approximately 23-31%. This provides clinical proof-of-concept for the inflammatory hypothesis of atherosclerosis (following the CANTOS trial with canakinumab). The 2024 ESC CCS Guidelines include colchicine as a consideration for secondary prevention (Class IIb). GI side effects are the main limitation. Colchicine is thought to inhibit NLRP3 inflammasome-mediated IL-1β and IL-18 production, reducing vascular inflammation.
Reference: ESC (2024): CCS Guidelines; COLCOT/LoDoCo2 Trials