Purpose of Review

Targeting traditional cardiovascular risk factors is effective in reducing recurrent cardiovascular events, yet the presence of residual cardiovascular risk due to underlying systemic inflammation is a largely unaddressed opportunity. This review aims to comprehensively assess the evolving role of colchicine as a therapeutic approach targeting residual inflammatory risk in the context of those with coronary artery disease (CAD).

Recent Findings

Inflammation plays a significant role in promoting atherosclerosis, and targeting anti-inflammatory pathways has the potential to decrease cardiovascular events. Low-dose colchicine (0.5 mg/day orally), when added to guideline-directed medical care for CAD, safely decreases major adverse cardiovascular events (MACE) by 31% in stable atherosclerosis patients and 23% in those after recent myocardial infarctions. Meta-analyses of recent randomized control trials further support both the efficacy and safety of colchicine, particularly when added to other standard cardiovascular therapies, including statin therapy. The European Society of Cardiology and other national guidelines endorse the use of low-dose colchicine in patients across the spectrum of CAD. Recently, colchicine was FDA-approved in the United States as the first anti-inflammatory therapy for the reduction of cardiovascular events. In a period of a rising incidence of CAD across the globe, colchicine represents a unique opportunity to decrease MACE due to its large magnitude of benefits and general affordability. However, challenges with drug interactions must be addressed, especially in those regions where HIV, hepatitis, and tuberculosis are prevalent.

Summary

Colchicine is safe and effective at reducing cardiovascular events across a broad spectrum of coronary syndromes. The ability to simultaneously target traditional risk factors and mitigate residual inflammatory risk marks a substantial advancement in cardiovascular prevention strategies, heralding a new era in the global battle against CAD.

中文翻译：

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秋水仙碱预防心血管疾病：潜在的全球实施

审查目的

针对传统心血管危险因素可有效减少心血管事件复发，但由于潜在的全身炎症而导致的残余心血管风险在很大程度上是一个尚未解决的机会。本综述旨在全面评估秋水仙碱作为针对冠状动脉疾病（CAD）患者残余炎症风险的治疗方法的不断演变的作用。

最近的发现

炎症在促进动脉粥样硬化中发挥着重要作用，针对抗炎途径有可能减少心血管事件。将低剂量秋水仙碱（口服 0.5 毫克/天）添加到针对 CAD 的指南指导医疗护理中时，可以安全地将稳定动脉粥样硬化患者的主要不良心血管事件 (MACE) 降低 31%，将近期心肌梗塞后的患者降低 23%。最近随机对照试验的荟萃分析进一步支持秋水仙碱的功效和安全性，特别是当添加到其他标准心血管疗法（包括他汀类药物疗法）时。欧洲心脏病学会和其他国家指南认可在各种 CAD 患者中使用低剂量秋水仙碱。最近，秋水仙碱在美国获得 FDA 批准，成为第一种减少心血管事件的抗炎疗法。在全球 CAD 发病率不断上升的时期，秋水仙碱因其巨大的益处和普遍的承受能力而成为减少 MACE 的独特机会。然而，必须解决药物相互作用的挑战，特别是在艾滋病毒、肝炎和结核病流行的地区。

概括

秋水仙碱可安全有效地减少多种冠状动脉综合征的心血管事件。同时针对传统风险因素和减轻残余炎症风险的能力标志着心血管预防策略的重大进步，预示着全球抗击 CAD 的新时代。