Colchicine in Patients with Chronic Coronary Disease

作者：Stefan M. Nidorf, Aernoud T.L. Fiolet, Arend Mosterd, John W. Eikelboom, Astrid Schut, Tjerk S.J. Opstal, Salem H.K. The, Xiao-Fang Xu, Mark A. Ireland, Timo Lenderink, Donald Latchem, Pieter Hoogslag, Anastazia Jerzewski, Peter R Nierop, Alan Whelan, Randall Hendriks, Henk P. Swart, Jeroen Schaap, Aaf F.M. Kuijper, M. W. J. van Hessen, Pradyot Saklani, Isabel Tan, Angus Thompson, Allison Morton, Chris Judkins, Willem A. Bax, Maurits T. Dirksen, Marco Alings, Graeme J. Hankey, Charley Budgeon, Jan G.P. Tijssen, Jan H. Cornel, Peter L. Thompson · 发表于：New England Journal of Medicine · 年份：2020 · DOI：10.1056/nejmoa2021372 · 被引用次数：2197 · 研究领域：Inflammasome and immune disorders、Biomarkers in Disease Mechanisms、Pericarditis and Cardiac Tamponade

BACKGROUND: Evidence from a recent trial has shown that the antiinflammatory effects of colchicine reduce the risk of cardiovascular events in patients with recent myocardial infarction, but evidence of such a risk reduction in patients with chronic coronary disease is limited. METHODS: In a randomized, controlled, double-blind trial, we assigned patients with chronic coronary disease to receive 0.5 mg of colchicine once daily or matching placebo. The primary end point was a composite of cardiovascular death, spontaneous (nonprocedural) myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization. The key secondary end point was a composite of cardiovascular death, spontaneous myocardial infarction, or ischemic stroke. RESULTS: A total of 5522 patients underwent randomization; 2762 were assigned to the colchicine group and 2760 to the placebo group. The median duration of follow-up was 28.6 months. A primary end-point event occurred in 187 patients (6.8%) in the colchicine group and in 264 patients (9.6%) in the placebo group (incidence, 2.5 vs. 3.6 events per 100 person-years; hazard ratio, 0.69; 95% confidence interval [CI], 0.57 to 0.83; P<0.001). A key secondary end-point event occurred in 115 patients (4.2%) in the colchicine group and in 157 patients (5.7%) in the placebo group (incidence, 1.5 vs. 2.1 events per 100 person-years; hazard ratio, 0.72; 95% CI, 0.57 to 0.92; P = 0.007). The incidence rates of spontaneous myocardial infarction or isc...