Grant: Project Grant

Inflammation is upregulated when plaques develop within the arterial wall (known as atherosclerosis), and following a heart attack, and when the inflammatory response is persistent this can have negative affects on heart function. In this context, it is increasingly being recognized that inflammation could play a key role in the progression of heart failure (HF) when it is due to blockages involving the coronary arteries (or ischemic heart disease). HF due to ischemic heart disease is the most common cause of HF worldwide. These patients are also at risk for further ischemic vascular events (such as a heart attack or stroke), and therefore inhibition of inflammation could have the dual role of preventing HF progression and preventing ischemic vascular events in this high-risk population. Colchicine is a potent anti-inflammatory drug, and this study will test whether it reduces the risk of both HF and ischemic cardiovascular events in patients with HF secondary to ischemic heart disease. This will be a clinical trial of 2500 participants with HF secondary to ischemic heart disease who will be randomly assigned to receive daily low dose colchicine or matching placebo, with planned follow up of about 3.5 years. The main outcome examined will be the composite of cardiovascular death, hospitalization for HF, heart attack, stroke or revascularization. If successful, this trial will identify a new method of treating HF secondary to ischemic heart disease.