May 14, 2025 • 12 mins
A revolutionary discovery in heart attack care emerges from the pages of the New England Journal of Medicine, where researchers have found an unexpected hero in colchicine—a medication derived from the autumn crocus plant and used for centuries to treat gout and other inflammatory conditions.
The COLCOT trial (Colchicine Cardiovascular Outcomes Trial) reveals something remarkable: this ancient, inexpensive anti-inflammatory medication reduced the risk of major cardiovascular events by 23% in patients recovering from heart attacks. Most strikingly, it slashed stroke risk by an astonishing 74% and halved the need for urgent procedures due to chest pain. These benefits appeared despite patients already receiving optimal standard care with statins, aspirin, and other treatments.
What makes this discovery particularly exciting is how it validates the inflammation hypothesis of heart disease. While we've long focused on cholesterol and blood clotting as primary targets in cardiovascular care, this research confirms inflammation isn't just a bystander but an active contributor to heart problems. By interfering with cellular microtubules and dampening inflammatory pathways, colchicine provides protection through an entirely different mechanism than our current approaches.
The implications reach far beyond academic interest. For the millions of people who suffer heart attacks each year, this readily available medication could transform recovery outcomes. Though researchers noted mild digestive side effects and a small increased pneumonia risk that warrants monitoring, the overall safety profile appeared favorable. This represents exactly the kind of innovative thinking we need to advance heart health—finding new uses for established medications with well-understood safety profiles. Could your heart health strategy benefit from addressing inflammation? Connect with us to explore how these cutting-edge findings might fit into your personal wellness journey.
Disclaimer:
The information provided in this podcast is for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before making changes to your supplement regimen or health routine. Individual needs and reactions vary, so it’s important to make informed decisions with the guidance of your physician.
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If you enjoyed today’s episode, be sure to subscribe, leave us a review, and share it with someone who might benefit. For more insights and updates, visit our website at Lifewellmd.com.
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Remember, informed choices lead to better health. Until next time, be well and take care of yourself.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the Deep Dive.
We're here to explore medicalresearch and really bring you
key insights for a healthierlife.
It's your fast track to stayinginformed.
Speaker 2 (00:09):
And we're part of the team at LifeWellMDcom here in
Florida focused on health,wellness and longevity.
Definitely check out thewebsite for more info.
Speaker 1 (00:17):
Today we are taking a deep dive into a well, a really
interesting study.
It just came out in the NewEngland Journal of Medicine.
Speaker 2 (00:26):
Yeah, it's looking at a potential game changer for
heart health and it involves adrug many folks already know.
Actually, Colchicine,colchicine you know, I think
most people like you said, theyhear colchicine, they think gout
right or maybe pericarditis,heart health probably doesn't
even come up.
Speaker 1 (00:43):
Yeah.
Speaker 2 (00:43):
So okay, let's unpack this.
This sounds really important.
Speaker 1 (00:45):
It is.
Speaker 2 (00:46):
Our mission today really is to understand what
this research found.
What could it mean forpreventing future heart problems
, specifically after a heartattack?
Speaker 1 (00:55):
Exactly, and this is the kind of, you know,
potentially transformativeinformation that we at Life LMD
are always tracking.
It could be crucial for yourwellness journey, definitely.
So.
To really get this colchicinestudy, we probably need some
background first.
Inflammation and heart disease,right.
What's the link there?
Speaker 2 (01:12):
Right.
Well, it's pretty wellestablished now.
We've known for quite a whilethat inflammation is a key
player in atherosclerosis.
Speaker 1 (01:20):
That's the plaque buildup in the arteries.
Speaker 2 (01:21):
Exactly the stuff that can lead to heart attacks
and strokes.
So inflammation is deeplyinvolved in that whole process.
Speaker 1 (01:28):
So it's not just, you know, cholesterol, there's this
whole other angle.
Weren't there some previousattempts to target inflammation
for heart disease?
How did those go?
Speaker 2 (01:35):
Yeah, there's been a lot of interest there.
So, for example, the CANTOStrial looked at a drug called
canakinumab.
It targeted a specificinflammatory protein and it did
show about a 15% lower risk ofcardiovascular events.
But there was a catch it alsoled to an increased risk of
serious infections, some evenfatal.
(01:57):
So, that was a major concern.
Speaker 1 (01:59):
Okay, not ideal.
Speaker 2 (02:00):
Not ideal.
Then there was another study,the CR trial, which looked at
methotrexate.
That's a commonanti-inflammatory drug.
Speaker 1 (02:07):
Right used for arthritis and things.
Speaker 2 (02:09):
Exactly, but unfortunately it showed no
benefit at all forcardiovascular outcomes in that
study.
Speaker 1 (02:15):
Huh, so the search was definitely still on for
something safe and effective.
Speaker 2 (02:19):
Precisely, which brings us back to colchicine.
Speaker 1 (02:21):
Okay, so colchicine, you said people know it.
It's not a new drug then.
Speaker 2 (02:25):
Oh, not at all, it's actually.
Well, it's ancient really.
It comes from the autumn crocusplant.
It's been used for centuries.
Speaker 1 (02:32):
Centuries wow.
Speaker 2 (02:33):
Yeah, and it's inexpensive.
You take it orally and it's apotent anti-inflammatory.
Speaker 1 (02:40):
So how does it work?
What's it doing inside the bodyto fight inflammation?
Speaker 2 (02:43):
Well, its main mechanism is pretty interesting.
It interferes with somethingcalled tubulin polymerization.
Basically, it messes with theinternal scaffolding, the
microtubules inside cells.
Speaker 1 (02:53):
Okay.
Speaker 2 (02:54):
And by doing that it seems to dampen down various
inflammatory pathways.
The study mentions effects onthings like cell adhesion
molecules, certain signalingchemicals called cumakines and
even this key immune complexcalled the inflammasome.
Speaker 1 (03:08):
The inflammasome.
That sounds important.
Speaker 2 (03:10):
It really is a central hub for inflammation.
Speaker 1 (03:12):
And just quickly, what's colchicine normally used
for the approved uses?
Speaker 2 (03:16):
Right.
So typically it's for gout, aswe mentioned also familial
Mediterranean fever, which is agenetic inflammatory condition,
and pericarditis that'sinflammation around the heart.
Speaker 1 (03:31):
Got it Now.
I feel like I heard somethingabout colchicine and heart
disease before this big study.
Was there an earlier trial?
Speaker 2 (03:35):
You're probably thinking of the LODOCO trial,
lodoco.
Speaker 1 (03:38):
LODOCO yeah.
Speaker 2 (03:39):
Yeah, that one looked at low-dose colchicine for
people with stable coronarydisease and it did suggest fewer
cardiovascular events.
But there's always a but Well,yeah, it was a smaller study and
, critically, it didn't have aplacebo group, it wasn't
placebo-controlled.
Speaker 1 (03:54):
Okay, so harder to know for sure if the drug was
really responsible.
Speaker 2 (03:57):
Exactly, which is why this new study, the COLCOT
trial, is such a big deal.
It was designed to give us muchclearer answers.
Speaker 1 (04:03):
COLCOT.
Ok, so tell us about the setup.
How did they design thisColcott trial?
Speaker 2 (04:09):
So Colcott stands for Colchicine Cardiovascular
Outcomes Trial, and its specificgoal was to rigorously test
Colchicine after a heart attack,looking at both cardiovascular
outcomes and long term safety.
Speaker 1 (04:21):
Right.
Speaker 2 (04:22):
It's a randomized double blind placebo controlled
trial.
That's really the gold standarddesign.
Speaker 1 (04:27):
Double-blind, meaning neither the patients nor the
doctors knew who was getting theactual colchicine and who got
the placebo correct.
Speaker 2 (04:33):
Precisely Minimizes bias.
Patients got a low dose, just0.5 milligrams once a day.
Speaker 1 (04:39):
Okay.
Speaker 2 (04:39):
And the participants were adults, all within 30 days
of having a heart attack.
Importantly, they'd already hadprocedures like angioplasty or
stents if needed, and they werealready on standard treatments.
Speaker 1 (04:51):
Standard treatments like statins.
Speaker 2 (04:52):
Yes, including intensive statin therapy,
aspirin, other anti-platelets.
That works guidelinerecommended care.
There were some exclusions, ofcourse, like people with severe
heart failure or who'd had avery recent stroke.
Speaker 1 (05:04):
Makes sense.
And what were they primarilylooking for?
What was the the primaryendpoint.
Speaker 2 (05:08):
The main thing they measured was a composite.
It included several majorevents bundled together death
from cardiovascular causes,resuscitated cardiac arrest,
another heart attack, stroke oran urgent hospitalization for
angina chest pain that requiredanother procedure like stenting.
Speaker 1 (05:24):
Okay, quite a comprehensive list.
How many people and for howlong.
Speaker 2 (05:27):
They enrolled 40745 patients and the median
follow-up time was around 22.6months, so almost two years.
Speaker 1 (05:35):
Almost two years.
Okay, the moment of truth.
What did they find?
What were the results?
Speaker 2 (05:39):
Well, the headline finding is that the primary
outcome was significantly lowerin the coltacine group.
Speaker 1 (05:44):
Significantly lower.
Speaker 2 (05:45):
Yes, it occurred in 5.5% of patients taking
coltacine, compared to 7.1percent in the placebo group.
That translates to a hazardratio of 0.77.
And the p-value was 0.02, whichindicates statistical
significance.
So a clear reduction in riskfor that combined endpoint.
Speaker 1 (06:04):
Wow, that's pretty impressive.
A 23 percent relative riskreduction roughly Right.
Can you break down that primaryendpoint?
Did colpsin affect all thosecomponents equally, or were some
drivers bigger than others?
Speaker 2 (06:15):
Great question and yes, there were differences.
The most striking effects wereseen for stroke and for urgent
hospitalization for anginaneeding revascularization.
Speaker 1 (06:26):
Really Stroke.
Speaker 2 (06:27):
Yeah, the risk of stroke was reduced substantially
.
The hazard ratio is 0.26.
That's a huge drop 74% relativereduction.
Speaker 1 (06:34):
That's amazing.
Speaker 2 (06:35):
It is, and for the urgent hospitalization for
angina needing a procedure, thehazard ratio was 0.50.
So basically a halving of thatrisk.
Speaker 1 (06:44):
Also very significant .
What about the other things?
Heart attack, cardiac arrest,cardiovascular death.
Speaker 2 (06:49):
For those components cardiovascular death,
resuscitating cardiac arrest andsubsequent myocardial
infarction the hazard ratiosactually weren't statistically
significant on their own.
Speaker 1 (06:59):
Oh, okay.
Speaker 2 (07:00):
The numbers sort of trended in the right direction,
favoring colchicine, but theydidn't reach statistical
significance individually.
So it looks like the overallbenefit was really driven by
that reduction in stroke and theurgent revascularization for
angina.
Speaker 1 (07:13):
I see.
So the main drivers were strokeand repeat procedures for chest
pain.
Did they look at any othercombined endpoints?
Speaker 2 (07:19):
They did.
They had a secondary endpointwhich was a composite of just
death from cardiovascular causes, cardiac arrest, mi or stroke.
Speaker 1 (07:28):
Yeah.
Speaker 2 (07:29):
So similar to the primary, but without the urgent
revascularization part.
For that secondary endpoint thehazard ratio was 0.85, and that
was not statisticallysignificant.
Speaker 1 (07:40):
Okay, but the primary endpoint, which included that
clinically important outcome ofneeding another procedure, was
significant.
Speaker 2 (07:47):
Correct.
That's the key takeaway onefficacy.
Speaker 1 (07:49):
And it's really worth stressing again right, this
benefit was seen in patients whoare already getting good
standard care aspirin, statins,everything.
Speaker 2 (07:56):
Absolutely.
That's what makes itpotentially so important.
It suggests colchicine isadding something on top of our
current best treatments.
It implies that targeting thisinflammation pathway gives an
extra layer of protection.
Speaker 1 (08:08):
Okay, crucial piece Now the flip side safety.
Any medication can have sideeffects.
What did they see withcolchicine in this trial?
Speaker 2 (08:15):
Good question.
Overall, the rate of adverseevents thought to be related to
the study drug was prettysimilar between the colchicine
and placebo groups.
The most commonly reportedthings, and perhaps expected
with colchicine, weregastrointestinal issues.
There was slightly morediarrhea in the colchicine group
, 9.7% versus 8.9%, though thatdifference wasn't statistically
(08:36):
significant.
Nausea was also a bit higher,1.8% versus 1.0% of that was
statistically significant.
Speaker 1 (08:42):
All right, so mostly some mild tummy upset.
Potentially Anything moreserious pop up.
Speaker 2 (08:47):
Yes, and this is important.
There was a higher incidence ofpneumonia reported as a serious
adverse event in the colchicinegroup.
It was 0.9% versus 0.4% in theplacebo group and that
difference was statisticallysignificant.
Pneumonia Okay.
(09:09):
That's also worth pointing outthat, unlike that canakinumab
drug from the Kantos trial,colchicine did not increase the
risk of septic shock.
Speaker 1 (09:16):
Right.
Speaker 2 (09:16):
And another reassuring point even though
almost all these patients wereon high-intensity statins, there
was no signal of serious muscleproblems or myopathy linked to
the colchicine.
Speaker 1 (09:26):
Okay, that's good news on the muscle front, given
the statin use, but thepneumonia signal is there.
So, pulling it all together,what are the main implications
here?
The big picture from Colcott.
Speaker 2 (09:37):
Well, the main conclusion is pretty clear
Low-dose colchicine given soonafter a heart attack
significantly cuts the risk ofmajor ischemic cardiovascular
events.
Speaker 1 (09:47):
Okay.
Speaker 2 (09:48):
And that benefit seems largely driven by reducing
strokes and the need for urgentprocedures due to angina.
Speaker 1 (09:54):
But we need to be a little careful about how far we
extend this right.
This was a specific grouppost-heart attack patients and
the follow-up was just under twoyears.
Speaker 2 (10:03):
That's exactly right.
It's a limitation.
We don't know the effectsbeyond that, say five or ten
years out.
So longer term studies aredefinitely needed to see if the
benefit holds up and if anysafety issues emerge over time.
And yes, these results applyspecifically to people who've
just had an MI.
We can't just assume it worksthe same way for, say, someone
with stable angina or othergroups.
Speaker 1 (10:22):
Makes sense.
But it really hammers home thatpoint about inflammation,
doesn't it?
It suggests tacklinginflammation directly.
Even with an old drug likecolchicine can make a real
difference, on top ofcontrolling cholesterol and
platelets.
Speaker 2 (10:35):
Precisely.
It adds significant weight tothe inflammation hypothesis of
cardiovascular disease.
It tells us that inflammationisn't just a bystander, it's an
active target for therapy.
Speaker 1 (10:47):
So, wrapping up here, this major study suggests that
colchicine a drug most people,maybe even many doctors, only
associate with gout, mightactually be a valuable tool
after a heart attack.
It's cheap, it's available andit seems to add another layer of
protection by reducinginflammation.
It's quite surprising really.
This kind of information couldgenuinely change how we approach
(11:08):
care after a heart attack.
It really underscores, you know, how much we're still learning
and the importance of lookingfor new angles in preventing
heart disease.
Speaker 2 (11:15):
Absolutely.
It's a great example of howongoing research, even with
older medications, can lead topotentially significant advances
for patients.
Speaker 1 (11:24):
And for you listening .
If you or someone you careabout has had a heart attack, or
if you're just keen on stayingahead of the curve with heart
health and prevention, well,this is exactly the kind of
cutting-edge research we followclosely here at LifeWellMDcom in
Florida.
That's right, we're committedto bringing these innovative
strategies in health, wellnessand longevity to our community.
If you want to learn more aboutthis colchicine research or
(11:47):
discuss how the latest sciencemight fit into your personal
wellness plan, please give ourteam at LifeWellMD a call.
The number is 561-210-9999.
Let us help you start yourpersonalized wellness journey
today.
Speaker 2 (12:01):
It really leaves you thinking, doesn't it?
What if this simple existingmedication could truly alter the
long-term path for heart healthin a way we're just now
starting to appreciate?
It opens up some very excitingpossibilities to explore further
.
Welcome to the Deep Dive.
We're here to explore medicalresearch and really bring you
key insights for a healthierlife.
It's your fast track to stayinginformed.
Speaker 2 (00:09):
And we're part of the team at LifeWellMDcom here in
Florida focused on health,wellness and longevity.
Definitely check out thewebsite for more info.
Speaker 1 (00:17):
Today we are taking a deep dive into a well, a really
interesting study.
It just came out in the NewEngland Journal of Medicine.
Speaker 2 (00:26):
Yeah, it's looking at a potential game changer for
heart health and it involves adrug many folks already know.
Actually, Colchicine,colchicine you know, I think
most people like you said, theyhear colchicine, they think gout
right or maybe pericarditis,heart health probably doesn't
even come up.
Speaker 1 (00:43):
Yeah.
Speaker 2 (00:43):
So okay, let's unpack this.
This sounds really important.
Speaker 1 (00:45):
It is.
Speaker 2 (00:46):
Our mission today really is to understand what
this research found.
What could it mean forpreventing future heart problems
, specifically after a heartattack?
Speaker 1 (00:55):
Exactly, and this is the kind of, you know,
potentially transformativeinformation that we at Life LMD
are always tracking.
It could be crucial for yourwellness journey, definitely.
So.
To really get this colchicinestudy, we probably need some
background first.
Inflammation and heart disease,right.
What's the link there?
Speaker 2 (01:12):
Right.
Well, it's pretty wellestablished now.
We've known for quite a whilethat inflammation is a key
player in atherosclerosis.
Speaker 1 (01:20):
That's the plaque buildup in the arteries.
Speaker 2 (01:21):
Exactly the stuff that can lead to heart attacks
and strokes.
So inflammation is deeplyinvolved in that whole process.
Speaker 1 (01:28):
So it's not just, you know, cholesterol, there's this
whole other angle.
Weren't there some previousattempts to target inflammation
for heart disease?
How did those go?
Speaker 2 (01:35):
Yeah, there's been a lot of interest there.
So, for example, the CANTOStrial looked at a drug called
canakinumab.
It targeted a specificinflammatory protein and it did
show about a 15% lower risk ofcardiovascular events.
But there was a catch it alsoled to an increased risk of
serious infections, some evenfatal.
(01:57):
So, that was a major concern.
Speaker 1 (01:59):
Okay, not ideal.
Speaker 2 (02:00):
Not ideal.
Then there was another study,the CR trial, which looked at
methotrexate.
That's a commonanti-inflammatory drug.
Speaker 1 (02:07):
Right used for arthritis and things.
Speaker 2 (02:09):
Exactly, but unfortunately it showed no
benefit at all forcardiovascular outcomes in that
study.
Speaker 1 (02:15):
Huh, so the search was definitely still on for
something safe and effective.
Speaker 2 (02:19):
Precisely, which brings us back to colchicine.
Speaker 1 (02:21):
Okay, so colchicine, you said people know it.
It's not a new drug then.
Speaker 2 (02:25):
Oh, not at all, it's actually.
Well, it's ancient really.
It comes from the autumn crocusplant.
It's been used for centuries.
Speaker 1 (02:32):
Centuries wow.
Speaker 2 (02:33):
Yeah, and it's inexpensive.
You take it orally and it's apotent anti-inflammatory.
Speaker 1 (02:40):
So how does it work?
What's it doing inside the bodyto fight inflammation?
Speaker 2 (02:43):
Well, its main mechanism is pretty interesting.
It interferes with somethingcalled tubulin polymerization.
Basically, it messes with theinternal scaffolding, the
microtubules inside cells.
Speaker 1 (02:53):
Okay.
Speaker 2 (02:54):
And by doing that it seems to dampen down various
inflammatory pathways.
The study mentions effects onthings like cell adhesion
molecules, certain signalingchemicals called cumakines and
even this key immune complexcalled the inflammasome.
Speaker 1 (03:08):
The inflammasome.
That sounds important.
Speaker 2 (03:10):
It really is a central hub for inflammation.
Speaker 1 (03:12):
And just quickly, what's colchicine normally used
for the approved uses?
Speaker 2 (03:16):
Right.
So typically it's for gout, aswe mentioned also familial
Mediterranean fever, which is agenetic inflammatory condition,
and pericarditis that'sinflammation around the heart.
Speaker 1 (03:31):
Got it Now.
I feel like I heard somethingabout colchicine and heart
disease before this big study.
Was there an earlier trial?
Speaker 2 (03:35):
You're probably thinking of the LODOCO trial,
lodoco.
Speaker 1 (03:38):
LODOCO yeah.
Speaker 2 (03:39):
Yeah, that one looked at low-dose colchicine for
people with stable coronarydisease and it did suggest fewer
cardiovascular events.
But there's always a but Well,yeah, it was a smaller study and
, critically, it didn't have aplacebo group, it wasn't
placebo-controlled.
Speaker 1 (03:54):
Okay, so harder to know for sure if the drug was
really responsible.
Speaker 2 (03:57):
Exactly, which is why this new study, the COLCOT
trial, is such a big deal.
It was designed to give us muchclearer answers.
Speaker 1 (04:03):
COLCOT.
Ok, so tell us about the setup.
How did they design thisColcott trial?
Speaker 2 (04:09):
So Colcott stands for Colchicine Cardiovascular
Outcomes Trial, and its specificgoal was to rigorously test
Colchicine after a heart attack,looking at both cardiovascular
outcomes and long term safety.
Speaker 1 (04:21):
Right.
Speaker 2 (04:22):
It's a randomized double blind placebo controlled
trial.
That's really the gold standarddesign.
Speaker 1 (04:27):
Double-blind, meaning neither the patients nor the
doctors knew who was getting theactual colchicine and who got
the placebo correct.
Speaker 2 (04:33):
Precisely Minimizes bias.
Patients got a low dose, just0.5 milligrams once a day.
Speaker 1 (04:39):
Okay.
Speaker 2 (04:39):
And the participants were adults, all within 30 days
of having a heart attack.
Importantly, they'd already hadprocedures like angioplasty or
stents if needed, and they werealready on standard treatments.
Speaker 1 (04:51):
Standard treatments like statins.
Speaker 2 (04:52):
Yes, including intensive statin therapy,
aspirin, other anti-platelets.
That works guidelinerecommended care.
There were some exclusions, ofcourse, like people with severe
heart failure or who'd had avery recent stroke.
Speaker 1 (05:04):
Makes sense.
And what were they primarilylooking for?
What was the the primaryendpoint.
Speaker 2 (05:08):
The main thing they measured was a composite.
It included several majorevents bundled together death
from cardiovascular causes,resuscitated cardiac arrest,
another heart attack, stroke oran urgent hospitalization for
angina chest pain that requiredanother procedure like stenting.
Speaker 1 (05:24):
Okay, quite a comprehensive list.
How many people and for howlong.
Speaker 2 (05:27):
They enrolled 40745 patients and the median
follow-up time was around 22.6months, so almost two years.
Speaker 1 (05:35):
Almost two years.
Okay, the moment of truth.
What did they find?
What were the results?
Speaker 2 (05:39):
Well, the headline finding is that the primary
outcome was significantly lowerin the coltacine group.
Speaker 1 (05:44):
Significantly lower.
Speaker 2 (05:45):
Yes, it occurred in 5.5% of patients taking
coltacine, compared to 7.1percent in the placebo group.
That translates to a hazardratio of 0.77.
And the p-value was 0.02, whichindicates statistical
significance.
So a clear reduction in riskfor that combined endpoint.
Speaker 1 (06:04):
Wow, that's pretty impressive.
A 23 percent relative riskreduction roughly Right.
Can you break down that primaryendpoint?
Did colpsin affect all thosecomponents equally, or were some
drivers bigger than others?
Speaker 2 (06:15):
Great question and yes, there were differences.
The most striking effects wereseen for stroke and for urgent
hospitalization for anginaneeding revascularization.
Speaker 1 (06:26):
Really Stroke.
Speaker 2 (06:27):
Yeah, the risk of stroke was reduced substantially
.
The hazard ratio is 0.26.
That's a huge drop 74% relativereduction.
Speaker 1 (06:34):
That's amazing.
Speaker 2 (06:35):
It is, and for the urgent hospitalization for
angina needing a procedure, thehazard ratio was 0.50.
So basically a halving of thatrisk.
Speaker 1 (06:44):
Also very significant .
What about the other things?
Heart attack, cardiac arrest,cardiovascular death.
Speaker 2 (06:49):
For those components cardiovascular death,
resuscitating cardiac arrest andsubsequent myocardial
infarction the hazard ratiosactually weren't statistically
significant on their own.
Speaker 1 (06:59):
Oh, okay.
Speaker 2 (07:00):
The numbers sort of trended in the right direction,
favoring colchicine, but theydidn't reach statistical
significance individually.
So it looks like the overallbenefit was really driven by
that reduction in stroke and theurgent revascularization for
angina.
Speaker 1 (07:13):
I see.
So the main drivers were strokeand repeat procedures for chest
pain.
Did they look at any othercombined endpoints?
Speaker 2 (07:19):
They did.
They had a secondary endpointwhich was a composite of just
death from cardiovascular causes, cardiac arrest, mi or stroke.
Speaker 1 (07:28):
Yeah.
Speaker 2 (07:29):
So similar to the primary, but without the urgent
revascularization part.
For that secondary endpoint thehazard ratio was 0.85, and that
was not statisticallysignificant.
Speaker 1 (07:40):
Okay, but the primary endpoint, which included that
clinically important outcome ofneeding another procedure, was
significant.
Speaker 2 (07:47):
Correct.
That's the key takeaway onefficacy.
Speaker 1 (07:49):
And it's really worth stressing again right, this
benefit was seen in patients whoare already getting good
standard care aspirin, statins,everything.
Speaker 2 (07:56):
Absolutely.
That's what makes itpotentially so important.
It suggests colchicine isadding something on top of our
current best treatments.
It implies that targeting thisinflammation pathway gives an
extra layer of protection.
Speaker 1 (08:08):
Okay, crucial piece Now the flip side safety.
Any medication can have sideeffects.
What did they see withcolchicine in this trial?
Speaker 2 (08:15):
Good question.
Overall, the rate of adverseevents thought to be related to
the study drug was prettysimilar between the colchicine
and placebo groups.
The most commonly reportedthings, and perhaps expected
with colchicine, weregastrointestinal issues.
There was slightly morediarrhea in the colchicine group
, 9.7% versus 8.9%, though thatdifference wasn't statistically
(08:36):
significant.
Nausea was also a bit higher,1.8% versus 1.0% of that was
statistically significant.
Speaker 1 (08:42):
All right, so mostly some mild tummy upset.
Potentially Anything moreserious pop up.
Speaker 2 (08:47):
Yes, and this is important.
There was a higher incidence ofpneumonia reported as a serious
adverse event in the colchicinegroup.
It was 0.9% versus 0.4% in theplacebo group and that
difference was statisticallysignificant.
Pneumonia Okay.
(09:09):
That's also worth pointing outthat, unlike that canakinumab
drug from the Kantos trial,colchicine did not increase the
risk of septic shock.
Speaker 1 (09:16):
Right.
Speaker 2 (09:16):
And another reassuring point even though
almost all these patients wereon high-intensity statins, there
was no signal of serious muscleproblems or myopathy linked to
the colchicine.
Speaker 1 (09:26):
Okay, that's good news on the muscle front, given
the statin use, but thepneumonia signal is there.
So, pulling it all together,what are the main implications
here?
The big picture from Colcott.
Speaker 2 (09:37):
Well, the main conclusion is pretty clear
Low-dose colchicine given soonafter a heart attack
significantly cuts the risk ofmajor ischemic cardiovascular
events.
Speaker 1 (09:47):
Okay.
Speaker 2 (09:48):
And that benefit seems largely driven by reducing
strokes and the need for urgentprocedures due to angina.
Speaker 1 (09:54):
But we need to be a little careful about how far we
extend this right.
This was a specific grouppost-heart attack patients and
the follow-up was just under twoyears.
Speaker 2 (10:03):
That's exactly right.
It's a limitation.
We don't know the effectsbeyond that, say five or ten
years out.
So longer term studies aredefinitely needed to see if the
benefit holds up and if anysafety issues emerge over time.
And yes, these results applyspecifically to people who've
just had an MI.
We can't just assume it worksthe same way for, say, someone
with stable angina or othergroups.
Speaker 1 (10:22):
Makes sense.
But it really hammers home thatpoint about inflammation,
doesn't it?
It suggests tacklinginflammation directly.
Even with an old drug likecolchicine can make a real
difference, on top ofcontrolling cholesterol and
platelets.
Speaker 2 (10:35):
Precisely.
It adds significant weight tothe inflammation hypothesis of
cardiovascular disease.
It tells us that inflammationisn't just a bystander, it's an
active target for therapy.
Speaker 1 (10:47):
So, wrapping up here, this major study suggests that
colchicine a drug most people,maybe even many doctors, only
associate with gout, mightactually be a valuable tool
after a heart attack.
It's cheap, it's available andit seems to add another layer of
protection by reducinginflammation.
It's quite surprising really.
This kind of information couldgenuinely change how we approach
(11:08):
care after a heart attack.
It really underscores, you know, how much we're still learning
and the importance of lookingfor new angles in preventing
heart disease.
Speaker 2 (11:15):
Absolutely.
It's a great example of howongoing research, even with
older medications, can lead topotentially significant advances
for patients.
Speaker 1 (11:24):
And for you listening .
If you or someone you careabout has had a heart attack, or
if you're just keen on stayingahead of the curve with heart
health and prevention, well,this is exactly the kind of
cutting-edge research we followclosely here at LifeWellMDcom in
Florida.
That's right, we're committedto bringing these innovative
strategies in health, wellnessand longevity to our community.
If you want to learn more aboutthis colchicine research or
(11:47):
discuss how the latest sciencemight fit into your personal
wellness plan, please give ourteam at LifeWellMD a call.
The number is 561-210-9999.
Let us help you start yourpersonalized wellness journey
today.
Speaker 2 (12:01):
It really leaves you thinking, doesn't it?
What if this simple existingmedication could truly alter the
long-term path for heart healthin a way we're just now
starting to appreciate?
It opens up some very excitingpossibilities to explore further
.
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