Colchicine use is associated with decreased prevalence of myocardial infarction in patients with gout.
OBJECTIVE
The ability of antiinflammatory strategies to alter cardiovascular risk has not been rigorously examined. Colchicine is an antiinflammatory agent that affects macrophages, neutrophils, and endothelial cells, all of which are implicated in the pathogenesis of cardiovascular disease. We examined whether colchicine use was associated with a reduced risk of myocardial infarction (MI) in patients with gout.


METHODS
We conducted a retrospective, cross-sectional study of all patients with an International Classification of Diseases, 9th ed, code for gout in the electronic medical record (EMR) of the New York Harbor Healthcare System Veterans Affairs network and ≥ 1 hospital visit between August 2007 and August 2008. Hospital pharmacy data were used to identify patients who had filled at least 1 colchicine prescription versus those who had not. Demographics and CV comorbidities were collected by EMR review. The primary outcome was diagnosis of MI. Secondary outcomes included all-cause mortality and C-reactive protein (CRP) level.


RESULTS
In total, 1288 gout patients were identified. Colchicine (n = 576) and no colchicine (n = 712) groups had similar baseline demographics and serum urate levels. Prevalence of MI was 1.2% in the colchicine versus 2.6% in the no-colchicine group (p = 0.03). Colchicine users also had fewer deaths and lower CRP levels, although these did not achieve statistical significance. Colchicine effects persisted when allopurinol users were excluded from the analysis.


CONCLUSIONS
In this hypothesis-generating study, gout patients who took colchicine had a significantly lower prevalence of MI and exhibited trends toward reduced all-cause mortality and lower CRP level versus those who did not take colchicine.
Crystal Diseases Study Group, Division of Rheumatology, New York University School of Medicine, New York, New York 10003, USA. daria.crittenden@nyumc.org
Daria B
DB
Crittenden
R Aaron
RA
Lehmann
Laura
L
Schneck
Robert T
RT
Keenan
Binita
B
Shah
Jeffrey D
JD
Greenberg
Bruce N
BN
Cronstein
Steven P
SP
Sedlis
Michael H
MH
Pillinger
D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D003078:Colchicine / Q000627:therapeutic use*; D005260:Female; D006073:Gout / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000517:prevention & control; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
D006074:Gout Suppressants; D014527:Uric Acid; D000493:Allopurinol; D002097:C-Reactive Protein; D003078:Colchicine