Inflammation is associated with MI (myocardial infarction) and CAD (coronary artery disease). Gout patients are at elevated MI risk. Colchicine has a minimized MI risk in gout patients. But it is doubtful whether colchicine can prevent the development of CAD. In a well-defined cohort of gout patients, it was found that among all-comer gout patients without known prior cardiovascular disease, colchicine may not be associated with a reduction in incident CAD. However, it may have a benefit in incident CAD in gout patients without CKD (chronic kidney disease).

This retrospective study aimed to examine whether colchicine can prevent the development of incident CAD in gout patients.

In the VA (Veterans Affairs) New York Harbor Healthcare System, a cohort of male gout patients without known CAD at the time of gout diagnosis were followed. Using an IPW (inverse probability-weighted) cox proportional hazard model, the association between colchicine use and the incident development of CAD (defined as evidence of ischemia or obstructive CAD on a stress test or angiography) was examined.

Out of 178,877 recruited subjects, 1,638 met the inclusion gout criteria. 722 subjects without any CAD incidence at baseline (276 non-users and 446 colchicine users) were examined for a median of about 96 months. No difference was witnessed in the rate of the primary outcome of non-MI incident CAD between the colchicine user and non-user groups.

The trend towards a link between colchicine use and diminished development of CAD was not found to be statistically significant. In CKD patients, colchicine use was associated with a lower rate of incident CAD as depicted in Table 1 and also with a lower rate of the composite of incident CAD and MI as depicted in Table 2:

In male subjects with gout and no known CAD, a trend of reduced incident CAD was witnessed with colchicine use that was not statistically significant.