Heart Podcast How does colchicine impact inflammation in the coronary arteries?
Jan 13, 2026
Dr. Arnoud Fiolet, a cardiologist and researcher at Utrecht University, dives into his groundbreaking work on colchicine and its impact on coronary artery inflammation. He discusses the LoDoCo2 trial, revealing how colchicine reduces major adverse cardiovascular events by about 25%. The conversation highlights how colchicine affects plaque composition through imaging, leading to greater plaque calcification. Arnoud addresses study limitations and emphasizes the need for further research to explore the drug's mechanisms—promising insights into heart disease management.
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Colchicine Shows Real Clinical Benefit
- Colchicine 0.5 mg daily reduced major adverse cardiovascular events by about 25% in trials of chronic and acute coronary syndromes.
- Guidelines in Europe and the US now recommend low-dose colchicine for some patients with coronary disease.
Designing LoDoCo2 Pragmatically
- Arnoud Fiolet described joining Mark Nidorf to design the LoDoCo2 trial testing low-dose colchicine in chronic coronary disease.
- They chose a pragmatic cardiovascular outcome trial with governmental support rather than early mechanistic studies.
PCAT As A Noninvasive Inflammation Marker
- Pericoronary adipose tissue (PCAT) attenuation on CCTA is a non-invasive surrogate for coronary plaque inflammation.
- PCAT attenuation becomes less negative with greater inflammatory activity and can be measured without histology.