Colchicine for Preserving Left Ventricular Systolic Function in Patients With STEMI Following Successful Primary PCI: A Speckle-Tracking Echocardiography Study

Background: Colchicine is a safe and well-tolerated medication in patients with cardiovascular disease. Speckle-tracking echocardiography (STE) with global longitudinal strain average is a validated method for evaluating left ventricular (LV) function. Utilizing 2D STE, this study aimed to investigate the safety and efficacy of colchicine administration on LV systolic function in anterior ST-segment elevation myocardial infarction (STEMI) patients following a successful primary percutaneous coronary intervention (PPCI). Methods: This randomized clinical trial involved 200 anterior STEMI patients who underwent successful PPCI, allocated to 2 groups: Group I (control group), receiving guideline- directed medical therapy (GDMT), and Group II (colchicine group), receiving both GDMT and colchicine (loading and maintenance dose) for 6 months. Assessment of LV systolic function was performed using Simpson's method, along with 2D STE and global longitudinal strain GLS averages. This evaluation was conducted for all patients during their hospital stay and followed up 6 months later. Results: Assessment of LV systolic function, measured as ejection fraction (EF [%]), calculated using Simpson's method, indicated a significant improvement in the colchicine group compared to the control group at the 6-month follow-up (EF = 41.38% +/- 3.98 in the colchicine group vs 39.38% +/- 7.74 in the control group; P = 0.011). Additionally, there was a highly statistically significant improvement in LV GLS average (- 13.28 +/- 2.13 in the colchicine group vs - 11.64 +/- 2.73 in the control group; P = 0.001). No significant difference was observed in the rate of acute and chronic complications during the followup between the control and colchicine groups. Conclusions: Colchicine administration in anterior STEMI patients following a successful PPCI was found to significantly improve LV systolic function without an increase in the incidence of complications. (Iranian Heart Journal 2024; 25(4): 84-95)