Anti-inflammatory treatment with colchicine in stable chronic heart failure: a prospective, randomized study.
OBJECTIVE
The purpose of this study was to test the efficacy of a 6-month course of anti-inflammatory treatment with colchicine in improving functional status of patients with stable chronic heart failure (CHF).


BACKGROUND
CHF has been shown to be associated with inflammatory activation. Inflammation has been designated as a therapeutic target in CHF.


METHODS
Patients with stable CHF were randomly assigned to colchicine (0.5 mg twice daily) or placebo for 6 months. The primary endpoint was the proportion of patients achieving at least one-grade improvement in New York Heart Association class.


RESULTS
Two hundred sixty-seven patients were available for final evaluation of the primary endpoint: its rate was 11% in the control group and 14% in the colchicine group (odds ratio: 1.40; 95% confidence interval: 0.67 to 2.93; p = 0.365). The rate of the composite of death or hospital stay for heart failure was 9.4% in the control group, compared with 10.1% in the colchicine group (p = 0.839). The changes in treadmill exercise time with treatment were insignificant and similar in the 2 groups (p = 0.938). C-reactive protein and interleukin-6 were both significantly reduced in the colchicine group (-5.1 mg/l and -4.8 pg/ml, respectively; p < 0.001 for both, compared with the control group).


CONCLUSIONS
According to this prospective, randomized study, anti-inflammatory treatment with colchicine in patients with stable CHF, although effective in reducing inflammation biomarker levels, did not affect in any significant way patient functional status (in terms of New York Heart Association class and objective treadmill exercise tolerance) or the likelihood of death or hospital stay for heart failure.
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece; Section of Cardiovascular Medicine, Yale University School of Medicine, Yale University, New Haven, Connecticut.
Spyridon
S
Deftereos
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece; Section of Cardiovascular Medicine, Yale University School of Medicine, Yale University, New Haven, Connecticut; Hellenic Center of Disease Control and Prevention Athens, Greece. Electronic address: ggiann@med.uoa.gr.
Georgios
G
Giannopoulos
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
Vasiliki
V
Panagopoulou
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
Georgios
G
Bouras
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
Konstantinos
K
Raisakis
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece; Hellenic Center of Disease Control and Prevention Athens, Greece.
Charalampos
C
Kossyvakis
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
Sofia
S
Karageorgiou
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
Charalampos
C
Papadimitriou
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
Maria
M
Vastaki
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
Andreas
A
Kaoukis
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
Christos
C
Angelidis
Third Department of Internal Medicine, Athens General Hospital "G. Gennimatas," Athens, Greece.
Stamatina
S
Pagoni
Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
Vlasios
V
Pyrgakis
Department of Cardiology, University of Patras Medical School, Patras, Greece.
Dimitrios
D
Alexopoulos
First Department of Cardiology, University of Athens Medical School, Athens, Greece.
Antonis S
AS
Manolis
First Department of Cardiology, University of Athens Medical School, Athens, Greece.
Christodoulos
C
Stefanadis
Section of Cardiovascular Medicine, Yale University School of Medicine, Yale University, New Haven, Connecticut.
Michael W
MW
Cleman
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002908:Chronic Disease; D003078:Colchicine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D017079:Exercise Tolerance / Q000187:drug effects; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein; D003078:Colchicine
C-reactive protein; colchicine; heart failure; inflammation; interleukin-6