Colchicine, traditionally used for the treatment of gout, has been investigated for its potential role in the management of acute coronary syndrome (ACS), which includes conditions such as unstable angina and myocardial infarction.

The primary mechanism of action of colchicine is its ability to inhibit microtubule formation and disrupt the inflammatory response by interfering with neutrophil function and migration.

colchicine has been proposed to have several beneficial effects:

1. Anti-inflammatory effects: Colchicine can reduce inflammation by inhibiting the release of pro-inflammatory cytokines and chemokines. This anti-inflammatory action may help stabilize atherosclerotic plaques and reduce the risk of plaque rupture, which is a common trigger for ACS.

2. Reduction of neutrophil activation: Colchicine can inhibit the activation and migration of neutrophils, which play a role in the inflammatory response associated with ACS. By reducing neutrophil activity, colchicine may help mitigate the inflammatory damage to the heart tissue.

3. Prevention of pericarditis: Colchicine has been shown to be effective in preventing recurrent pericarditis, which can be a complication of ACS. By reducing pericardial inflammation, colchicine may help alleviate symptoms and prevent further episodes of pericarditis.

However, it's important to note that the use of colchicine in ACS is still an area of ongoing research, and guidelines may vary depending on the country and medical association.

Although Colchicine having anti-inflammatory role but Additon of cochione to standard medical Treatment does not significantly affects cardiovascular vascular at 12 month in ACS patients , even increase the mortality in ACS

Colchicine has shown beneficial results in recent trials for ACS patients, due to its anti-inflammatory nature thus reducing future cardiovascular events.

The COLCOT trial of Colchicine, unfortunately, had to be discontinued due to the potent gastric side effects of this particular medication. However, because of the potential to reduce inflammation, it was again investigated at lower dosages- LoDoCo2 trial which was based on a previous pilot trial called LoDoCo. The incidence rates of spontaneous MI, ischaemic stroke and cardiovascular death are significantly lower compared to placebo.

Colchicine having anti inflammatory action might be role in ACS but outcome at 12 month is non significant event increase the mortality

Several studies mentioned that Colchicine can protect ACS patients against ischemic events. However, it isn’t statistically significant .

doi : 10.1097/FJC.0000000000001319

Definitely colchicine is protective against ACS but more study needed to prove its utility on long term outcome

Definitely role of colchicine in ACS but Efficacy is time sensitive