Abstract Body (Do not enter title and authors here): Background:
Despite optimal therapy, coronary artery disease (CAD) remains a significant public health concern in the United States. The literature increasingly acknowledges the role of inflammation in the development of atherosclerosis. Colchicine, a potent anti-inflammatory drug commonly used to treat gout and pericarditis, is being evaluated in this study for its safety and efficacy in preventing CAD following an acute coronary syndrome (ACS).

Methods:
We searched PubMed and Embase to find studies up to April 2024 that compared colchicine to placebo in patients with ACS. The primary outcomes were major adverse cardiovascular events (MACE), stroke, recurrent ACS, and recurrent hospitalizations. Secondary endpoints consisted of cardiovascular death and the incidence of congestive heart failure (CHF). We also examined the gastrointestinal effects of colchicine in all subjects. To combine the data, we used the random-effects model.

Results:

We included ten studies with a pooled sample size of 7,260 patients. The mean age was 60.1 (±11.8) years, with 19.3% females and an average follow-up duration of 8.5 (±6) months. Patients who received colchicine treatment demonstrated a reduced risk of MACE (OR: 0.72, 95% CI: 0.59-0.88, p- 0.001), stroke (OR: 0.41, 95% CI: 0.20-0.84, p- 0.01), recurrent ACS (OR: 0.73, 95% CI: 0.57-0.93, p- 0.01), and hospitalization (OR: 0.52, 95% CI: 0.34-0.81, p- 0.003). However, there was no significant difference in cardiovascular death (OR: 1.01, 95% CI: 0.60-1.72, p- 0.95) and the incidence of CHF (OR: 1.04, 95% CI: 0.64-1.69, p-0.89) between patients treated with colchicine and those without. Notably, patients treated with colchicine experienced more gastrointestinal effects than those without colchicine treatment (OR: 1.16, 95% CI: 1.02-1.32, p-0.02).

Conclusion:
Adding colchicine to standard medical therapy in ACS patients significantly reduced the incidence of major adverse cardiovascular events, stroke, recurrent ACS events, and hospitalizations. Further prospective trials are required to validate these findings and determine if early intervention with colchicine treatment improves clinical outcomes in ACS patients.