Use of Colchicine in the Reduction of Cardiovascular Atherosclerotic Events

Introduction: Atherosclerosis begins when the injured artery wall creates chemical signals that cause certain types of leukocytes (monocytes and T cells) to adhere to the artery wall. These cells move towards the artery wall. There, they are transformed into foam cells that collect cholesterol and other fatty materials and trigger the growth of smooth muscle cells in the artery wall. Colchicine or colchicine is a highly poisonous alkaloid, originally extracted from the plant Colchicum autumnale. It has been used in the treatment of various diseases, but on an increasingly smaller scale due to its high toxicity. Aim: The aim of this review is to provide a balanced, critical and comprehensive assessment of the evidence currently available regarding the use of colchicine in the context of atherosclerotic heart disease. Material and Methods: The research was carried out by means of an electronic search for scientific articles published on the Scielo (Scientific Electronic Library Online) and Lilacs (Latin American Health Sciences Literature) and Pubmed websites. The health terminologies consulted in the Health Sciences Descriptors (DeCS/BIREME) were used: r use of Colchicine in the reduction of atherosclerotic cardiovascular events. Results and Discussion: Although there was variation between individual studies, meta-analyses also showed that colchicine reduced the risk of myocardial infarction, stroke or cardiovascular death by between 20 and 30%. The applicability of the results may vary according to subsets of patients. For example, the benefits of colchicine may be even greater in patients with diabetes mellitus. However, as most studies excluded patients with heart failure and chronic kidney disease, the effects of colchicine in these populations are still unknown. Final considerations: if the use of colchicine in the treatment of ischemic heart disease is to be fully viable, a great effort must be made to personalize its use in terms of timing, duration of treatment and dose, reassessing the net clinical benefit of this strategy over time, taking into account the underlying severity of CV disease, the patient's comorbidities and the use of concomitant medications.