Effects of colchicine adjuvant therapy on disease control, serum NALP3, sICAM-1, MMP-9 and MMP-13 in patients with coronary heart disease and acute gout attack

TL;DR

Adding colchicine to standard treatment improves outcomes for patients with heart disease and acute gout by reducing inflammation and improving heart and blood vessel function.

Contribution

This study demonstrates that colchicine adjuvant therapy reduces inflammatory markers and improves cardiac and vascular function in patients with coronary heart disease and acute gout.

Findings

Colchicine improved clinical efficacy, with a higher total effective rate in the treatment group.

Colchicine reduced levels of NALP3, MMP-9, and MMP-13, and improved cardiac and vascular function indicators.

The treatment group had fewer major adverse cardiovascular events compared to the control group.

Abstract

To investigate the impact of colchicine adjuvant therapy on disease control and serum levels of nucleotide-binding oligomerization domain-like receptor (NALP) 3, soluble intercellular adhesion molecule (sICAM)-1, matrix metalloproteinase (MMP)-9, and MMP13 in patients with coronary heart disease (CHD) complicated by acute gout attacks.

Ninety-two patients with CHD and acute gout attacks admitted to our hospital from October 2021 to January 2023 were randomly divided into an observation group and a control group, with 46 patients in each group. The control group received conventional treatment, while the observation group received colchicine adjuvant therapy on top of the control group's treatment for 7 days. Clinical efficacy in both groups was assessed. Before and after treatment, cardiac function indicators (left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPWT)), vascular endothelial function indicators (sICAM-1, endothelin-1 (ET-1), and vascular endothelial growth factor (VEGF)), inflammatory factors (NALP3, MMP-9, MMP-13) levels, changes in immune cell populations (CD3+ lymphocytes, CD3+CD4+ lymphocytes, CD3+CD8+ lymphocytes ratio, and CD3+CD4+/CD3+CD8+ ratio) were compared, and the incidence of adverse reactions was recorded. Three months after treatment, the occurrence of major adverse cardiovascular events was also recorded.

The total effective rate in the observation group was significantly higher than that in the control group (93.48% vs 79.07%) (P<0.05). After treatment, the levels of NALP3, MMP-9, and MMP-13 in both groups decreased, with the observation group being lower than the control group (P<0.05). After treatment, LVPWT and LVEDD levels in the observation group were lower than those in the control group, and LVEF was higher (P<0.05). After treatment, the levels of ET-1 and sICAM-1 in the observation group were lower than those in the control group, and VEGF levels were higher (P<0.05). After treatment, the proportions of CD3+ lymphocytes, CD3+CD4+ lymphocytes, and CD3+CD4+/CD3+CD8+ ratio were significantly higher in the observation group than in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). The occurrence of major adverse cardiovascular events in the observation group was lower than that in the control group (2.17% vs 13.04%).

Colchicine adjuvant therapy improves the efficacy of CHD patients with acute gout attacks, helps improve cardiac function and vascular endothelial function, reduces serum levels of NALP3, sICAM-1, MMP-9, and MMP-13, enhances patient immunity, and controls disease progression.

Figures