%0 Journal Article
%T Inflammation and platelet reactivity during adjunctive colchicine versus aspirin in patients with acute coronary syndrome treated with potent P2Y12 inhibitor.
%A Lee SY
%A Cho JY
%A Gorog DA
%A Angiolillo DJ
%A Yun KH
%A Ahn JH
%A Koh JS
%A Park Y
%A Hwang SJ
%A Hwang JY
%A Kim JW
%A Jang Y
%A Jeong YH
%J Front Med (Lausanne)
%V 11
%N 0
%D 2024
%M 38841588
%F 5.058
%R 10.3389/fmed.2024.1349577
%X <B>UNASSIGNED: </B>In patients undergoing percutaneous coronary intervention (PCI), the use of anti-inflammatory therapy with colchicine is associated with a reduction of recurrent ischemic events. The mechanisms of such findings are not fully elucidated.<BR><B>UNASSIGNED: </B>To investigate the effects of colchicine versus aspirin on inflammation and platelet reactivity in patients with acute coronary syndrome (ACS) undergoing PCI.<BR><B>UNASSIGNED: </B>This observational study compared laboratory measurements in ACS patients receiving single antiplatelet therapy with ticagrelor or prasugrel plus colchicine (MACT) (n = 185) versus conventional dual-antiplatelet therapy (DAPT) with aspirin plus ticagrelor or prasugrel (n = 497). The primary outcome was the frequency of high residual inflammation, defined as high-sensitivity C-reactive protein (hs-CRP) ≥2 mg/L at 1 month post-PCI. Multiple sensitivity analyses were performed for the primary outcome, including multivariable adjustment, propensity-score matching, and inverse-probability weighted methods.<BR><B>UNASSIGNED: </B>One month after PCI, patients treated with MACT had significantly lower levels of hs-CRP compared to those treated with DAPT (0.6 [0.4-1.2] vs. 0.9 [0.6-2.3] mg/L, p < 0.001). The frequency of high residual inflammation was also lower in the MACT group (10.8% vs. 27.2%, p < 0.001) (odds ratio [95% confidence interval] = 0.33 [0.20-0.54], p < 0.001). This effect was consistent across sensitivity analyses. There was no difference in platelet reactivity between MACT and DAPT (49.6 ± 49.0 vs. 51.5 ± 66.4 P2Y12 reaction unit [PRU] measured by VerifyNow, p = 0.776).<BR><B>UNASSIGNED: </B>In ACS patients undergoing PCI, MACT was associated with a lower rate of high residual inflammation without increasing platelet reactivity compared to conventional DAPT.<BR><B>UNASSIGNED: </B>NCT04949516 for MACT pilot trial and NCT04650529 for Gyeongsang National University Hospital registry.