https://doi.org/10.4081/monaldi.2026.3897
Efficacy and safety of colchicine in patients with myocardial infarction: a systematic review and meta-analysis
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Published: 2 September 2026
Colchicine is an anti-inflammatory drug that has emerged as a potential treatment option following myocardial infarction (MI). This meta-analysis assesses the efficacy and safety of colchicine in patients following an MI. A comprehensive literature search was performed using the Cochrane Library, ClinicalTrials.gov, Embase, and MEDLINE, covering studies from their inception to December 2025. RevMan was used to perform a random-effects meta-analysis, and forest plots were used to visualize pooled estimates. The Mantel-Haenszel method was applied to analyze dichotomous outcomes. Nine randomized control trials (RCTs) were included in this meta-analysis, including 13,834 patients. The analysis revealed that there was no statistically significant difference between colchicine and placebo groups in all-cause mortality [relative risk (RR)=0.93, confidence interval (CI)=0.78-1.11], cardiac death (RR=0.95, CI=0.73-1.22), MI (RR=0.82, CI=0.67-1.00), stroke (RR=0.64, CI=0.26-1.58), adverse events (RR=1.01, CI=0.85-1.21), serious adverse events (RR=0.96, CI=0.87-1.05), serious gastrointestinal adverse events (RR=1.35, CI=0.94-1.95), and serious infections (RR=1.00, CI=0.62-1.62). However, there was an increased risk of diarrhea in people with colchicine compared to the placebo (RR=2.12, CI=1.35-3.32). This meta-analysis demonstrates that colchicine following an MI does not have a significant impact on cardiovascular events or major adverse events other than an increased risk of diarrhea. There is a need for more comprehensive RCTs with longer follow-up times to fully comprehend the potential cardiovascular benefits of colchicine.
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CDC. NHANES 2015-2016 overview. Available from: https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/overview.aspx?BeginYear=2015
Ridker PM. How common is residual inflammatory risk? Circ Res 2017;120:617-9. DOI: https://doi.org/10.1161/CIRCRESAHA.116.310527
Ridker PM, Bhatt DL, Pradhan AD, et al. Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials. Lancet 2023;401:1293-301. DOI: https://doi.org/10.1016/S0140-6736(23)00215-5
Zhang FS, He QZ, Qin CH, et al. Therapeutic potential of colchicine in cardiovascular medicine: a pharmacological review. Acta Pharmacol Sin 2022;43:2173-90. DOI: https://doi.org/10.1038/s41401-021-00835-w
Zhang CY, Liu S, Sui YX, Yang M. Nucleotide-binding domain, leucine-rich repeat, and pyrin domain-containing protein 3 inflammasome: from action mechanism to therapeutic target in clinical trials. World J Gastrointest Oncol 2025;17:100094. DOI: https://doi.org/10.4251/wjgo.v17.i2.100094
Adler Y, Charron P, Imazio M, et al. 2015 ESC guidelines for the diagnosis and management of pericardial diseases: the Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2015;36:2921-64. DOI: https://doi.org/10.1093/eurheartj/ehv318
Nidorf SM, Eikelboom JW, Budgeon CA, Thompson PL. Low-dose colchicine for secondary prevention of cardiovascular disease. J Am Coll Cardiol 2013;61:404-10. DOI: https://doi.org/10.1016/j.jacc.2012.10.027
Younas A, Awan Z, Khan T, et al. The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials. Curr Probl Cardiol 2025;50:102878. DOI: https://doi.org/10.1016/j.cpcardiol.2024.102878
Jolly SS, d’Entremont MA, Lee SF, et al. Colchicine in acute myocardial infarction. N Engl J Med 2025;392:633-42. DOI: https://doi.org/10.1056/NEJMoa2405922
Akodad M, Lattuca B, Nagot N, et al. COLIN trial: value of colchicine in the treatment of patients with acute myocardial infarction and inflammatory response. Arch Cardiovasc Dis 2017;110:395-402. DOI: https://doi.org/10.1016/j.acvd.2016.10.004
Akrami M, Izadpanah P, Bazrafshan M, et al. Effects of colchicine on major adverse cardiac events in next 6-month period after acute coronary syndrome occurrence; a randomized placebo-control trial. BMC Cardiovasc Disord 2021;21:583. DOI: https://doi.org/10.1186/s12872-021-02393-9
Bouleti C, Viscogliosi S, Bresson D, et al. Colchicine in acute myocardial infarction: cardiovascular events at 1-year follow up. Open Heart 2024;11:e002474. DOI: https://doi.org/10.1136/openhrt-2023-002474
Deftereos S, Giannopoulos G, Angelidis C, et al. Anti-inflammatory treatment with colchicine in acute myocardial infarction. Circulation 2015;132:1395-403. DOI: https://doi.org/10.1161/CIRCULATIONAHA.115.017611
Hennessy T, Soh L, Bowman M, et al. The low dose colchicine after myocardial infarction (LoDoCo-MI) study: a pilot randomized placebo controlled trial of colchicine following acute myocardial infarction. Am Heart J 2019;215:62-9. DOI: https://doi.org/10.1016/j.ahj.2019.06.003
Mewton N, Roubille F, Bresson D, et al. Effect of colchicine on myocardial injury in acute myocardial infarction. Circulation 2021;144:859-69. DOI: https://doi.org/10.1161/CIRCULATIONAHA.121.056177
Roubille F, Bouabdallaoui N, Kouz S, et al. Low-dose colchicine in patients with type 2 diabetes and recent myocardial infarction in the colchicine cardiovascular outcomes Trial (COLCOT). Diabetes Care 2024;47:467-70. DOI: https://doi.org/10.2337/dc23-1825
Tardif JC, Kouz S, Waters DD, et al. Efficacy and safety of low-dose colchicine after myocardial infarction. N Engl J Med 2019;381:2497-505. DOI: https://doi.org/10.1056/NEJMoa1912388
Chen T, Liu G, Yu B. Colchicine for coronary artery disease: a review. Front Cardiovasc Med 2022;9:892588. DOI: https://doi.org/10.3389/fcvm.2022.892588
Park HJ. Anti-inflammatory effects of colchicine on coronary artery disease. Cardiovasc Prev Pharmacother 2022;4:7-12. DOI: https://doi.org/10.36011/cpp.2022.4.e5
Yu M, Yang Y, Dong SL, et al. Effect of colchicine on coronary plaque stability in acute coronary syndrome as assessed by optical coherence tomography: the COLOCT randomized clinical trial. Circulation 2024;150:981-93. DOI: https://doi.org/10.1161/CIRCULATIONAHA.124.069808
Shah B, Allen N, Harchandani B, et al. Effect of colchicine on platelet-platelet and platelet-leukocyte interactions: a pilot study in healthy subjects. Inflammation 2016;39:182-9. DOI: https://doi.org/10.1007/s10753-015-0237-7
Diaz-Arocutipa C, Benites-Meza JK, Chambergo-Michilot D, et al. Efficacy and Safety of colchicine in post-acute myocardial infarction patients: a systematic review and meta-analysis of randomized controlled trials. Front Cardiovasc Med 2021;8:676771. DOI: https://doi.org/10.3389/fcvm.2021.676771
Leung YY, Hui LLY, Kraus VB. Colchicine --- update on mechanisms of action and therapeutic uses. Semin Arthritis Rheum 2015;45:341-50. DOI: https://doi.org/10.1016/j.semarthrit.2015.06.013
Sadiq NM, Robinson KJ, Terrell JM. Colchicine. Treasure Island, FL, USA: StatPearls Publishing; 2025.
CRediT authorship contribution
Muhammad Furqan Saleem: conception of the study, methodology design, and initial drafting of the manuscript. Tuba Ashraf: literature search, screening of articles, and data extraction. Ahmed Mekki: data collection, quality assessment of studies, and manuscript editing. Usama Siddique: literature search, data analysis, and drafting of results. Muhammad Usama Javed: methodology design, data interpretation, and critical revision of the manuscript. Chaudhry Bilal Rauf: data extraction, reference management, and manuscript formatting. Chaudhary Hammad Jamil: statistical analysis, preparation of tables and figures, and results interpretation. Azaz Ali Shah: screening of articles, data charting, and drafting of results. Muhammad Usman Haider: data verification, critical review of methodology, and manuscript editing. Salman Ahsan: manuscript writing, proofreading, and editing. Mohammad Ebad Ur Rehman: conceptual guidance, data synthesis, and critical review of discussion. Huzaifa Ahmad Cheema: data interpretation, drafting of discussion, and final editing. Bilawal Nadeem, Raheel Ahmed: supervision, critical revision for intellectual content, and approval of the final manuscript. All the authors have read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work.
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