Can Colchicine be a New Captain in Coronary Artery Disease Management? A Systematic Review

Despite the control of the conventional modifiable factors, many patients are still experiencing life-threatening first and recurrent cardiovascular events. Inflammation has a key role in all stages of development and progression of atherosclerosis. A detailed understanding of its role and the cellular dynamics, which contribute to atherosclerotic inflammation, is important in finding agents suitable to target it. The recent CANTOS trial highlighted that the interleukin1b inhibitor canakinumab could improve outcomes after acute coronary syndrome; however, being a high and increased risk of infections limited its administration for long-term treatment. Drugs acting on targets outside the interleukin-1b pathway failed to show clinical benefits. The most likely emerging anti-inflammatory agent low-dose colchicine is an affordable, safe, and more accessible alternative. This review aims at highlighting the role of inflammation in atherosclerosis and coronary artery diseases and the role of colchicine, an anti-inflammatory agent in patients with coronary artery disease, including both stable coronary artery disease and acute coronary syndrome.