Evidence map›Paper›PMID 40727715›Full record

ArticleAmerican heart journal plus : cardiology research and practice2025

Clinical benefit and cost effectiveness of adding life-time low-dose colchicine as secondary prevention following coronary artery bypass grafting surgery.

Sai Rahul Ponnana, Gauranga Mahalwar, Joris Holtrop, Steven H J Hageman, Tong Zhang, Santosh Kumar Sirasapalli, Skanda Moorthy, Zhuo Chen, Jean-Eudes Dazard, Sadeer Al-Kindi and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American heart journal plus : cardiology research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Sai Rahul PonnanaHarrington Heart and Vascular Institute, University Hospitals, Cleveland, USA.
Gauranga MahalwarDepartment of Internal Medicine, Cleveland Clinic, Cleveland, USA.
Joris HoltropDepartment of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
Steven H J HagemanDepartment of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
Tong ZhangHarrington Heart and Vascular Institute, University Hospitals, Cleveland, USA.
Santosh Kumar SirasapalliHarrington Heart and Vascular Institute, University Hospitals, Cleveland, USA.
Skanda MoorthyHarrington Heart and Vascular Institute, University Hospitals, Cleveland, USA.
Zhuo ChenHarrington Heart and Vascular Institute, University Hospitals, Cleveland, USA.
Jean-Eudes DazardHarrington Heart and Vascular Institute, University Hospitals, Cleveland, USA.
Sadeer Al-KindiDivision of Cardiology, Houston Methodist Hospital, Houston, USA.
Yakov ElgudinHarrington Heart and Vascular Institute, University Hospitals, Cleveland, USA.
Naveed SattarSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
Sanjay RajagopalanHarrington Heart and Vascular Institute, University Hospitals, Cleveland, USA.
Salil V DeoLouis Stokes Cleveland VA Medical Center, Cleveland, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Low-dose Colchicine therapy has demonstrated clinical benefit as secondary preventive therapy in patients with chronic coronary artery disease. While prior studies have reported its cost-effectiveness in this patient group, this has not yet been studied in post-coronary artery bypass grafting (CABG) patients. Therefore, we evaluated the 5-year potential clinical benefit and lifetime cost-effectiveness of adding low-dose Colchicine to routine secondary preventive therapy among U.S. Veterans post-CABG. Methods: A discrete time-homogeneous, annual cycle, state-transition Markov Chain model was developed using MACE (myocardial infarction, stroke, coronary reintervention, and all-cause mortality) information from 27,443 U.S. Veterans who underwent CABG. Cost and utility estimates were sourced from peer-reviewed literature. Current secondary preventive therapy was compared with secondary preventive therapy + Colchicine over a 35-year period. Clinical benefit was extrapolated from a nationwide perspective. Cost-effectiveness was modeled by calculating incremental cost-effectiveness ratios (ICERs) across a wide range of willingness-to-pay (WTP) thresholds. Deterministic, probabilistic, and alternative real-world scenarios were modeled to evaluate real-world use. Results: In 150,000 isolated CABG patients who received surgery in 2019 across the U.S., Colchicine therapy could potentially reduce 8266 myocardial infarctions, 16,674 strokes, and 9472 coronary reinterventions over 5 years. Lifetime Colchicine therapy yielded a QALY gain of 0.74 and an ICER of $26,684 per QALY. Monte Carlo simulation supported these findings (median ICER: $19,598; IQR: $17,995-$20,921). Colchicine remained cost-effective at WTP thresholds >$20,000 per QALY, even with 5-year or mixed adherence. Conclusion: Adjunct life-long Colchicine therapy may reduce cardiovascular events at an acceptable additional cost post-CABG.

Identifiers

PMID40727715
PMCPMC12303075

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.