Abstract
Acute coronary syndrome (ACS) remains one of the leading causes of cardiovascular morbidity and mortality, largely due to the high incidence of recurrent adverse events. Colchicine, a traditional anti-inflammatory drug primarily used for the treatment of gout, has emerged as a potential therapeutic option in cardiovascular care due to its ability to stabilize atherosclerotic plaques. This systematic review aimed to evaluate the efficacy of colchicine in reducing cardiovascular events and inflammatory biomarkers in patients with ACS. Eight studies published between 2013 and 2024 were included, selected through a comprehensive search of databases such as PubMed, ScienceDirect, Cochrane Library, and SciELO, as well as manual searches in scientific journals like the New England Journal of Medicine and via the Google Scholar search engine. Eligibility criteria included randomized, double-blind, placebo-controlled clinical trials assessing patients diagnosed with ACS. A total of 18,759 patients were analyzed, 9,369 in the intervention group (colchicine 0.5 mg/day plus standard treatment) and 9,390 in the placebo group, with follow-up periods ranging from three months to three years. Both primary outcomes (major cardiovascular events including myocardial infarction, stroke, and recurrent ischemia) and secondary outcomes (reduction of inflammatory biomarkers such as hs-CRP and IL-6 and incidence of adverse effects) were assessed. The results demonstrated that colchicine was associated with a significant reduction in hs-CRP and IL-6 levels, as well as a lower incidence of adverse cardiovascular events, particularly myocardial infarction and recurrent myocardial ischemia. In conclusion, colchicine may represent a promising adjunctive therapeutic alternative for patients with ACS, particularly due to its anti-inflammatory effects and potential role in secondary prevention. However, further studies with greater methodological consistency and long-term follow-up are required to confirm these benefits.