Early Colchicine Therapy Following Percutaneous Coronary Intervention to Reduce Peri-Stent Inflammation and In-Stent Restenosis : A Randomized Controlled Trial

Abstract

Background: Vascular injury during percutaneous coronary intervention (PCI) triggers an inflammatory response that may contribute to neointimal proliferation and early luminal narrowing despite drug-eluting stent use. Objective: To evaluate whether early low-dose colchicine added to standard post-PCI therapy reduces inflammatory biomarkers and improves short-term angiographic outcomes compared with standard therapy alone. Methods: This prospective, single-center, parallel-group randomized controlled trial enrolled 80 adults aged 35–70 years undergoing successful PCI with drug-eluting stent implantation. Participants were randomized 1:1 to colchicine 0.5 mg once daily plus standard care or standard care alone for 6 weeks. hs-CRP and IL-6 were measured at baseline and 6 weeks, while minimal lumen diameter and in-stent luminal narrowing were assessed by quantitative coronary angiography. Complete follow-up data were available for 75 participants. Between-group comparisons, repeated-measures analysis of variance, and Pearson correlation were used. Results: At 6 weeks, hs-CRP was lower with colchicine than control (1.64±0.42 vs 3.12±0.65 mg/L; mean difference −1.48, 95% CI −1.73 to −1.23; p<0.001), as was IL-6 (3.18±0.82 vs 5.62±1.10 pg/mL; mean difference −2.44, 95% CI −2.89 to −1.99; p<0.001). Minimal lumen diameter was larger (2.68±0.31 vs 2.41±0.35 mm; p<0.001), and in-stent luminal narrowing was lower (12.4±3.8% vs 20.2±5.1%; p<0.001). Conclusion: Early colchicine initiation was associated with greater short-term reductions in inflammatory biomarkers and more favorable 6-week angiographic measurements after PCI, although longer-term clinical benefit cannot be established from these data