Colchicine effect on biomarkers of cardiac remodelling and atherosclerosis in ST‐elevation myocardial infarction: A randomized controlled trial

Aims Owing to its underlying inflammatory nature, atherosclerotic cardiovascular disease remains the leading global cause of mortality, particularly post‐ST‐elevation myocardial infarction (STEMI), a condition with significant risk for further cardiovascular events and mortality. This study aimed to investigate colchicine's effect on inflammation, cardiac remodelling and atherosclerotic risk in STEMI patients. Methods We conducted a randomized controlled study on 88 STEMI patients undergoing percutaneous coronary intervention. Eligible patients were randomly assigned to 1 of 2 groups. The control group received the guideline‐directed medical therapy for STEMI, and the test group received guideline‐directed medical therapy and 0.5 mg colchicine twice daily for 3 months. The soluble suppressor of tumorigenicity (sST2), interleukin‐1β, lipid profile parameters, triglyceride (TG)/high‐density lipoprotein (HDL‐C) ratio levels and left ventricular ejection fraction were evaluated for patients at baseline and the end of the 3 months. Results No significant effects were reported for colchicine on sST2, interleukin‐1β levels or left ventricular ejection fraction. Colchicine significantly lowered TG levels vs . controls, 134 (46–353) vs . 176 (72–825) respectively, P = .02, as well as TG/HDL‐C ratio levels, 4.16 (2.75–5.24) vs . 5.11 (3.51–8.33),` respectively, P = .024. sST2 levels of the studied cohort were positively correlated with their TG/HDL‐C ratio levels ( R = .459, P < .001) at the end of follow‐up. Conclusion Our study highlights a promising impact of colchicine on atherosclerosis and cardiac remodelling factors in STEMI patients. Colchicine significantly reduced TG levels and TG/HDL‐C ratio and was safe and well tolerated. Larger long‐term studies powered to assess clinical outcomes of remodelling are necessary to confirm its beneficial effects in STEMI. Clinicaltrial.gov registration ID NCT06054100.