Role of Colchicine in Reduction of No Reflow Phenomenon in Patients with Acute ST-Segment Myocardial Infarction, Undergoing Primary Percutaneous Coronary Intervention

Abstract

orldwide, ischemic heart disease is the single most common cause of death and its frequency is increasing. STEMI is a significant cause of morbidity and mortality in patients with coronary heart disease. PCI is considered to be the preferred reperfusion strategy for acute coronary syndrome (ACS). Despite optimal evidence-based PCI, periprocedural myocardial injury (PMI) and myocardial no-reflow phenomenon can still occur and are associated with a worse in-hospital and long-term prognosis. Angiographic no-reflow is defined as less than TIMI 3 flow or TIMI 3 flow with MBG 0 or 1 without angiographic evidence of mechanical vessel obstruction. Colchicine is an inexpensive, orally-administered, potent anti-inflammatory medication that was initially extracted from the autumn crocus plant and has been used for centuries. This anti-inflammatory effect of colchicine has been recently shown to improve cardiovascular outcomes in patients with STEMI, at a daily dose of colchicine 0.5mg.