Effect of low-dose colchicine on pericoronary inflammation and coronary plaque composition in chronic coronary disease: a subanalysis of the LoDoCo2 trial.
Authors
Affiliations (18)
Affiliations (18)
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands [email protected].
- Dutch Network for Cardiovascular Research (WCN), Utrecht, The Netherlands.
- Monash Victorian Heart Institute and Monash Health Heart, Victorian Heart Hospital, Clayton, Victoria, Australia.
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Centre, Los Angeles, California, USA.
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland.
- Faculty of Medicine, Amsterdam University Medical Centre Amsterdam, Amsterdam, The Netherlands.
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
- Department of Cardiology, Zuyderland Medical Centre, Heerlen, The Netherlands.
- Department of Cardiology, Amsterdam University Medical Centre Amsterdam, Amsterdam, The Netherlands.
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
- Department of Cardiology, Northwest Clinics, Alkmaar, The Netherlands.
- Cardiac Imaging Division, Department of Nuclear Medicine, Noordwest Ziekenhuisgroep, Alkmaar, Noord-Holland, The Netherlands.
- Department of Cardiology, Amphia Hospital, Breda, The Netherlands.
- Department of Radiology, Amphia Hospital, Breda, The Netherlands.
- Department of Radiology, Meander MC, Amersfoort, The Netherlands.
- Heart and Vascular Research Institute of Western Australia, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
- Department of Cardiology, Meander MC, Amersfoort, The Netherlands.
Abstract
Low-dose colchicine (0.5 mg once daily) reduces the risk of major cardiovascular events in coronary disease, but its mechanism of action is not yet fully understood. We investigated whether low-dose colchicine is associated with changes in pericoronary inflammation and plaque composition in patients with chronic coronary disease. We performed a cross-sectional, nationwide, subanalysis of the Low-Dose Colchicine 2 Trial (LoDoCo2, n=5522). CT angiography studies were performed in 151 participants randomised to colchicine or placebo coronary after a median treatment duration of 28.2 months. Pericoronary adipose tissue (PCAT) attenuation measurements around proximal coronary artery segments and quantitative plaque analysis for the entire coronary tree were performed using artificial intelligence-enabled plaque analysis software. Median PCAT attenuation was not significantly different between the two groups (-79.5 Hounsfield units (HU) for colchicine versus -78.7 HU for placebo, p=0.236). Participants assigned to colchicine had a higher volume (169.6 mm<sup>3</sup> vs 113.1 mm<sup>3</sup>, p=0.041) and burden (9.6% vs 7.0%, p=0.035) of calcified plaque, and higher volume of dense calcified plaque (192.8 mm<sup>3</sup> vs 144.3 mm<sup>3</sup>, p=0.048) compared with placebo, independent of statin therapy. Colchicine treatment was associated with a lower burden of low-attenuation plaque in participants on a low-intensity statin, but not in those on a high-intensity statin (p<sub>interaction</sub>=0.037). Pericoronary inflammation did not differ among participants who received low-dose colchicine compared with placebo. Low-dose colchicine was associated with a higher volume of calcified plaque, particularly dense calcified plaque, which is considered a feature of plaque stability.