부산대학교 도서관

ABSTRACT: Primary percutaneous coronary intervention (PPCI) is the gold standard of treatment in patients with acute ST elevation myocardial infarction (STEMI). The no-reflow phenomenon (NRP) is a detrimental consequence of STEMI. Colchicine is an anti-inflammatory drug which may help prevent the NRP and improve patient outcomes. In a randomized, double-blind, placebo-controlled clinical trial, 451 patients with acute STEMI who were candidates for PPCI and eligible for enrollment were randomized into the colchicine group (n=229) and the control group (n=222). 321 patients were eligible to participate; 161 patients were assigned to the colchicine group, while 160 were assigned to the control group. Colchicine was administered 1 mg before PCI and 0.5 mg daily after the procedure until discharge. NRP, measured by angiographic findings including the thrombolysis in myocardial infarction (TIMI) flow grade and the TIMI myocardial perfusion grade (TMPG) was reported as the primary outcome. Secondary endpoints included ST resolution 90 minutes after the procedure, P-selectin, high sensitivity-C Reactive Protein (hs-CRP), and troponin levels post-procedurally, pre-discharge ejection fraction (EF), and major adverse cardiac events (MACE) at 1 month and 1 year following PPCI. NRP rates did not show a significant difference between the two groups (p = 0.98). Moreover, the levels of P-selectin, hs-CRP, and troponin were not significantly different. MACE and pre-discharge EF were also not significantly different between the groups. In STEMI patients treated by PPCI, colchicine administered before PPCI was not associated with a significant reduction in the NRP and MACE prevention (trial registration: IRCT20120111008698N23).