Ply Chichareon, Ruedeekorn Suwannanon, Metus Thungthienthong, Warath Chantaksinopas, Thammarak Songsangjinda, Theerapat Buppodom, Thanapon Nilmoje, Chinnawudh Sawee, Veerapong Vattanavanit, Polathep Vichitkunakorn, Supattra Uppanisakorn, Boonjing Siripaitoon, Saranyou Suwanugsorn, R Krittayaphong
BACKGROUND: Left ventricular hypertrophy (LVH) contributes to a substantial risk of adverse outcomes in patients with coronary artery disease (CAD). Inflammation is one of the mechanisms responsible for LVH progression. The study aimed to test the efficacy of colchicine, an anti-inflammatory agent, to reduce left ventricular mass in patients with CAD and LVH. METHODS: Sixty-six patients with CAD, LVH and controlled blood pressure were randomly assigned to colchicine 0.6 mg daily or placebo for 48 weeks after a run-in period. The primary endpoint was changes in left ventricular mass index (LVMI) measured by cardiac magnetic resonance imaging. RESULTS: (interquartile range -5.61, 5.50) in the placebo group. The absolute difference in the LVMI changes between the two groups was 0.57 g/m2 (95% confidence interval -5.61 to 4.1) with adjusted p value of 0.66. No significant differences in changes in left ventricular volume, left atrial volume, high-sensitivity C-reactive protein, insulin levels, haemoglobin A1c or body mass index were observed between the two groups. CONCLUSION: The study failed to demonstrate a treatment benefit of colchicine over placebo regarding LVMI reduction at 48 weeks. Given the early termination of the study, the results are inconclusive as the study was underpowered to detect small but potentially clinically meaningful differences.