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Time-to-treatment initiation of colchicine and cardiovascular outcomes after myocardial infarction in the Colchicine Cardiovascular Outcomes Trial (COLCOT)

2020-08-29Journal article Open access
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dc.contributor.authorBouabdallaoui, Nadia
dc.contributor.authorTardif, Jean-Claude
dc.contributor.authorWaters, David D.
dc.contributor.authorPinto, Fausto J.
dc.contributor.authorMaggioni, Aldo P.
dc.contributor.authorDiaz, Rafael
dc.contributor.authorBerry, Colin
dc.contributor.authorKoenig, Wolfgang
dc.contributor.authorLopez-Sendon, Jose
dc.contributor.authorGamra, Habib
dc.contributor.authorKiwan, Ghassan S.
dc.contributor.authorBlondeau, Lucie
dc.contributor.authorOrfanos, Andreas
dc.contributor.authorIbrahim, Reda
dc.contributor.authorGrégoire, Jean C.
dc.contributor.authorDubé, Marie-Pierre
dc.contributor.authorSamuel, Michelle
dc.contributor.authorMorel, Olivier
dc.contributor.authorLim, Pascal
dc.contributor.authorBertrand, Olivier F.
dc.contributor.authorKouz, Simon
dc.contributor.authorGuertin, Marie-Claude
dc.contributor.authorL'Allier, Philippe L.
dc.contributor.authorRoubille, François
dc.date.accessioned2020-09-10T15:41:57Z
dc.date.available2020-09-10T15:41:57Z
dc.date.issued2020-08-29
dc.description© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.compt_PT
dc.description.abstractAims: The COLchicine Cardiovascular Outcomes Trial (COLCOT) demonstrated the benefits of targeting inflammation after myocardial infarction (MI). We aimed to determine whether time-to-treatment initiation (TTI) influences the beneficial impact of colchicine. Methods and results: In COLCOT, patients were randomly assigned to receive colchicine or placebo within 30 days post-MI. Time-to-treatment initiation was defined as the length of time between the index MI and the initiation of study medication. The primary efficacy endpoint was a composite of cardiovascular death, resuscitated cardiac arrest, MI, stroke, or urgent hospitalization for angina requiring coronary revascularization. The relationship between endpoints and various TTI (<3, 4–7 and >8 days) was examined using multivariable Cox regression models. Amongst the 4661 patients included in this analysis, there were 1193, 720, and 2748 patients, respectively, in the three TTI strata. After a median follow-up of 22.7 months, there was a significant reduction in the incidence of the primary endpoint for patients in whom colchicine was initiated < Day 3 compared with placebo [hazard ratios (HR) = 0.52, 95% confidence intervals (CI) 0.32–0.84], in contrast to patients in whom colchicine was initiated between Days 4 and 7 (HR = 0.96, 95% CI 0.53–1.75) or > Day 8 (HR = 0.82, 95% CI 0.61–1.11). The beneficial effects of early initiation of colchicine were also demonstrated for urgent hospitalization for angina requiring revascularization (HR = 0.35), all coronary revascularization (HR = 0.63), and the composite of cardiovascular death, resuscitated cardiac arrest, MI, or stroke (HR = 0.55, all P < 0.05). Conclusion: Patients benefit from early, in-hospital initiation of colchicine after MI.pt_PT
dc.description.sponsorshipThe COLCOT trial was supported by the Government of Quebec, the Canadian Institutes of Health Research, the Montreal Heart Institute Foundation and other philanthropic foundations. The funding sources had no role in study design, conduct, or analyses.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEuropean Heart Journal, 29 August 2020pt_PT
dc.identifier.doi10.1093/eurheartj/ehaa659pt_PT
dc.identifier.eissn1522-9645
dc.identifier.issn0195-668X
dc.identifier.urihttp://hdl.handle.net/10451/44341
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Presspt_PT
dc.relation.publisherversionhttps://academic.oup.com/eurheartjpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectCardiovascular inflammationpt_PT
dc.subjectTime-to-treatment initiationpt_PT
dc.subjectColchicinept_PT
dc.subjectCOLCOTpt_PT
dc.subjectInflammasomept_PT
dc.titleTime-to-treatment initiation of colchicine and cardiovascular outcomes after myocardial infarction in the Colchicine Cardiovascular Outcomes Trial (COLCOT)pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleEuropean Heart Journalpt_PT
person.familyNamePinto
person.givenNameFausto J.
person.identifier1308889
person.identifier.ciencia-idC311-AEDD-6DBB
person.identifier.orcid0000-0002-8034-4529
person.identifier.ridG-9363-2015
person.identifier.scopus-author-id7102740158
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication5f44176f-69f5-482c-83cd-ab94425a6ec3
relation.isAuthorOfPublication.latestForDiscovery5f44176f-69f5-482c-83cd-ab94425a6ec3

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