Role of Colchicine in Cardiovascular Disorders

Author:

Moras Errol1,Subramanian Lakshmi2,Romeo Francisco3,Gandhi Kruti1,Prabhakaran Sivaguha Yadunath4,Moras Adlyn5,Krittanawong Chayakrit6,Frishman William H.7,Aronow Wilbert S.8

Affiliation:

1. Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

2. Department of Internal Medicine, East Carolina University, Greenville, NC

3. Division of Cardiology, Department of Medicine, University of Miami/Jackson Memorial Hospital, Miami, FL

4. Department of Internal Medicine, Mercy Catholic Medical Centre Darby, PA

5. Department of Medicine, Father Muller Medical College, Mangalore, KA, India

6. Division of Cardiology, Department of Medicine, NYU Langone Health/ NYU School of Medicine, New York, NY

7. Department of Medicine, New York Medical College, Valhalla, NY

8. Departments of Medicine and Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY.

Abstract

Inflammation has played a pivotal role in atherosclerosis and other cardiovascular disorders, prompting the exploration of anti-inflammatory therapies to improve cardiovascular outcomes. Colchicine, a well-established agent in conditions such as gout and familial Mediterranean fever, has emerged as a promising novel anti-inflammatory agent in the realm of cardiovascular diseases. Its ability to target both traditional risk factors and residual inflammatory risk marks a significant advancement in cardiovascular prevention strategies, indicating a new era in cardiovascular care. Landmark trials have supported the efficacy and safety of low-dose colchicine in reducing major adverse cardiovascular events when combined with standard therapies. In addition, its endorsement by major cardiovascular societies underscores its significance as the first targeted anti-inflammatory therapy for cardiovascular disease. However, careful monitoring for drug interactions and adverse effects, particularly on kidney and liver function, is essential for safe use. In this review, we aim to comprehensively summarize the mechanisms of action of colchicine, its molecular and biochemical targets in various cardiovascular conditions, and its pharmacokinetics, and delve deeply into the existing evidence on its safety and efficacy in the treatment of cardiovascular disorders, including coronary artery disease, pericarditis, atrial fibrillation, and heart failure.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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