Project summary
Colchicine cardiovascular outcomes in acute coronary syndrome study – imaging/biomarker substudy.
What is the issue for NSW?
Inflammation plays a critical role in rupture (or bursting) of atherosclerotic plaques in the wall of blood vessels supplying heart muscle, leading to cessation of blood flow and resulting in a heart attack, the leading cause of death in Australia. Despite current guideline-directed treatments, approximately 20% of patients who have had a heart attack remain at high risk of future heart attacks, predominantly because current therapies do not specifically target the inflammatory component of atherosclerosis.
What does the research aim to do and how?
Colchicine is a commonly used and well tolerated anti-inflammatory agent, used to treat a variety of non-cardiovascular diseases (for example gout). This project aims, for the first time, to investigate whether colchicine can specifically inhibit the inflammation that drives atherosclerotic plaque rupture leading to a heart attack. This outcome will be assessed by utilisation of cutting edge imaging techniques of the heart and large arteries of the neck (which commonly develop atherosclerosis).
The team will also follow these patients for up to three years to determine whether colchicine therapy reduces future heart events. This study has the potential to (1) increase our understanding of the role of inflammation in patients that have had a heart attack and are at risk of future heart attacks, and (2) demonstrate that colchicine, an inexpensive and well tolerated currently available drug, decreases future heart attacks in this high risk population, in a cost-effective fashion. In turn, the team expect their findings will change heart attack management to include colchicine in current guidelines.