ArticleAmerican journal of preventive cardiology2026
The effect of colchicine on pericoronary adipose tissue attenuation by serial coronary CT angiography: A substudy of the Ekstrom trial.
Article in American journal of preventive cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Inflammation plays a pivotal role in initiation and progression of coronary artery disease (CAD). Pericoronary adipose tissue (PCAT) attenuation on coronary CT angiography (CCTA) is a novel non-invasive biomarker of coronary inflammation. Low dose colchicine has been shown to safely lower cardiovascular events among patients with stable CAD. We sought to investigate whether colchicine is associated with changes in PCAT by serial CCTA in patients enrolled in the Effect of Colchicine on Progression of Known Coronary Atherosclerosis in Patients with STable CoROnary Artery Disease CoMpared to Placebo (EKSTROM) trial. Methods: This is a post-hoc analysis of the EKSTROM trial, a prospective, placebo-controlled serial CCTA trial that randomized patients with stable CAD to receive either colchicine (0.5 mg/day) or placebo, and followed for 12 months. PCAT attenuation was quantified using partially-automated Medis QAngioCT software. Multivariable linear regression models were adjusted for traditional cardiovascular risk factors and baseline PCAT attenuation to examine the change in mean PCAT attenuation between the treatment groups. Results: The analysis included 71 participants (12% female, mean age 64.6 ± 7.3, mean hsCRP 0.8 mg/L). Mean PCAT attenuation in the colchicine group was -73.6 HU ±8.0 at baseline which increased to -73.1 HU ±8.2 at 12-month follow-up. Mean PCAT attenuation in the placebo group was -75.3 HU ±7.4 at baseline, which increased to 74.5 HU ±6.8 at follow-up, with a between group change of 0.3 HU ±8.0 ( Conclusion: Colchicine was not associated with a significant change in PCAT over 12 months in participants in the EKSTROM trial with stable CAD. Larger studies with long-term follow up are needed to evaluate the mechanistic benefits of colchicine on the complex interactions of coronary atherosclerosis, inflammation, and adverse CV risk.
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