Background—: Inflammatory processes have been identified as key mediators of the deleterious effects of ischemia/reperfusion in ST-segment–elevation myocardial infarction. Colchicine is a substance with potent anti-inflammatory properties, suitable for safe use in patients with cardiovascular disease. The purpose of this study was to test the hypothesis that a short course of colchicine treatment could lead to reduced infarct size. Methods and Results—: Patients presenting with ST-segment–elevation myocardial infarction ≤12 hours from pain onset (treated with primary percutaneous coronary intervention) were randomly assigned to colchicine or placebo for 5 days. The primary outcome parameter was the area under the curve of creatine kinase-myocardial brain fraction concentration. A subset of patients underwent cardiac MRI with late gadolinium enhancement 6 to 9 days after the index ST-segment–elevation myocardial infarction. One hundred fifty-one patients were included (60 in the MRI substudy). The area under the creatine kinase-myocardial brain fraction curve was 3144 (interquartile range [IQR], 1754–6940) ng·h ^–1 ·mL ^–1 in the colchicine group in comparison with 6184 (IQR, 4456–6980) ng·h ^–1 ·mL ^–1 in controls ( P <0.001). Indexed MRI-late gadolinium enhancement–defined infarct size was 18.3 (IQR, 7.6–29.9) mL/1.73 m ² in the colchicine group versus 23.2 (18.5–33.4) mL/1.73 m ² in controls ( P =0.019). The relative infarct size (as a proportion to left ventricular myocardial volume) was 13.0 (IQR, 8.0–25.3) % and 19.8 (IQR, 13.7–29.8) %, respectively ( P =0.034). Conclusions—: These results suggest a potential benefit of colchicine in ST-segment–elevation myocardial infarction, but further clinical trials are necessary to draw secure conclusions, especially considering the fact that the present study was not powered to assess clinical end points. Clinical Trial Registration—: URL: http://www.clinicaltrials.gov . Unique identifier: NCT01936285.

Colchicine has been utilized safely in a variety of cardiovascular clinical conditions. Among its potential mechanisms of action is the non-selective inhibition of NLRP3 inflammasome which is thought to be a major pathophysiologic component in the clinical course of patients with COVID-19. GRECCO-19 will be a prospective, randomized, open-labeled, controlled study to assess the effects of colchicine in COVID-19 complications prevention. Patients with laboratory confirmed SARS-CoV-2 infection (under RT PCR) and clinical picture that involves temperature >37.5 oC and at least two out of the: i. sustained coughing, ii. sustained throat pain, iii. Anosmia and/or ageusia, iv. fatigue/tiredness, v. PaO2<95 mmHg will be included. Patients will be randomised (1:1) in colchicine or control group. Trial results will be disseminated through peer-reviewed publications and conference presentations. GRECCO-19 trial aims to identify whether colchicine may positively intervene in the clinical course of COVID-19. (ClinicalTrials.gov Identifier: NCT04326790).

The selection of patients with atrial fibrillation (AF) that will benefit most by left atrial ablation remains suboptimal. CHADS₂ score has been shown to be associated with post-ablation AF recurrences. However, data regarding the CHA₂DS₂-VASc score are lacking. In addition, there is paucity of data regarding the exact predictive value, in terms of sensitivity and specificity, of each of these scores as to AF recurrence. This study aimed to evaluate the merit of the CHADS₂ and CHA₂DS₂-VASc scores in predicting arrhythmia recurrence after a single ablation procedure for paroxysmal AF. One hundred and twenty-six patients (78 males, median age 61 years) with symptomatic paroxysmal AF underwent left atrial ablation. Over 16 months (interquartile range: 10.8–26.0), 89 patients were recurrence-free (70.6%). Larger left atrial volume (P: 0.039), diabetes (P: 0.001), dyslipidemia (P: 0.003), coronary artery disease (P: 0.003), class III antiarrhythmic drugs (P: 0.017), CHADS₂ (P: 0.006), and CHA₂DS₂-VASc (P: 0.016) scores were univariately associated with recurrence. In the multivariate analysis, both CHADS₂ (hazard ratio: 1.91, 95% confidence interval 1.09–3.36, P: 0.023) and CHA₂DS₂-VASc (hazard ratio: 1.97, 95% confidence interval 1.16–3.33, P: 0.012) were independently associated with AF recurrence. Cut-off analysis showed that a score ≥2 for both the CHADS₂ (sensitivity = 46% and specificity = 79%, area under the Receiver's operating characteristic curve, AUC = 0.644) and CHA₂DS₂-VASc score (sensitivity = 57% and specificity = 65%, AUC = 0.627) showed the highest predictive value for AF recurrence. CHA₂DS₂-VASc score is an independent predictor of left atrial ablation outcomes for paroxysmal AF, with a similar predictive value to CHADS₂. However, the predictive accuracy of both is mediocre.