Document Detail


Colchicine use is associated with decreased prevalence of myocardial infarction in patients with gout.
MedLine Citation:
PMID:  22660810     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The ability of antiinflammatory strategies to alter cardiovascular risk has not been rigorously examined. Colchicine is an antiinflammatory agent that affects macrophages, neutrophils, and endothelial cells, all of which are implicated in the pathogenesis of cardiovascular disease. We examined whether colchicine use was associated with a reduced risk of myocardial infarction (MI) in patients with gout.
METHODS: We conducted a retrospective, cross-sectional study of all patients with an International Classification of Diseases, 9th ed, code for gout in the electronic medical record (EMR) of the New York Harbor Healthcare System Veterans Affairs network and ≥ 1 hospital visit between August 2007 and August 2008. Hospital pharmacy data were used to identify patients who had filled at least 1 colchicine prescription versus those who had not. Demographics and CV comorbidities were collected by EMR review. The primary outcome was diagnosis of MI. Secondary outcomes included all-cause mortality and C-reactive protein (CRP) level.
RESULTS: In total, 1288 gout patients were identified. Colchicine (n = 576) and no colchicine (n = 712) groups had similar baseline demographics and serum urate levels. Prevalence of MI was 1.2% in the colchicine versus 2.6% in the no-colchicine group (p = 0.03). Colchicine users also had fewer deaths and lower CRP levels, although these did not achieve statistical significance. Colchicine effects persisted when allopurinol users were excluded from the analysis.
CONCLUSION: In this hypothesis-generating study, gout patients who took colchicine had a significantly lower prevalence of MI and exhibited trends toward reduced all-cause mortality and lower CRP level versus those who did not take colchicine.
Authors:
Daria B Crittenden; R Aaron Lehmann; Laura Schneck; Robert T Keenan; Binita Shah; Jeffrey D Greenberg; Bruce N Cronstein; Steven P Sedlis; Michael H Pillinger
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-06-01
Journal Detail:
Title:  The Journal of rheumatology     Volume:  39     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-03     Completed Date:  2012-11-26     Revised Date:  2013-08-14    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1458-64     Citation Subset:  IM    
Affiliation:
Crystal Diseases Study Group, Division of Rheumatology, New York University School of Medicine, New York, New York 10003, USA. daria.crittenden@nyumc.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Allopurinol / therapeutic use
C-Reactive Protein / analysis
Colchicine / therapeutic use*
Female
Gout / blood,  drug therapy*,  epidemiology
Gout Suppressants / therapeutic use*
Humans
Male
Middle Aged
Myocardial Infarction / epidemiology*,  prevention & control
New York / epidemiology
Prevalence
Retrospective Studies
Treatment Outcome
Uric Acid / blood
Grant Support
ID/Acronym/Agency:
5T32AR007176/AR/NIAMS NIH HHS; T32 HL098129/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Gout Suppressants; 315-30-0/Allopurinol; 64-86-8/Colchicine; 69-93-2/Uric Acid; 9007-41-4/C-Reactive Protein
Comments/Corrections

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