Tri Astiawati, Mohammad Saifur Rohman, Titin Wihastuti, Hidayat Sujuti, Agustina Tri Endharti, Djanggan Sargowo, Delvac Oceandy, Bayu Lestari, Efta Triastuti, Ricardo Adrian Nugraha
Background: Caspase-1 (reflects NOD-like receptor protein 3 inflammasome activity), transforming growth factor-β (TGF-β), and Galectin-3 play significant roles in post-AMI fibrosis and inflammation. Recently, colchicine was shown to dampen inflammation after AMI; however, its direct benefit remains controversial. Objectives: This study aimed to analyze the benefit of colchicine in reducing NT-proBNP, Caspase-1, TGF-β,and Galectin-3 expression and improving systolic–diastolic echocardiography parameters among AMI patients. Methods: A double-blinded, placebo-controlled, randomized, multicenter clinical trial was conducted at three hospitals in East Java, Indonesia: Dr. Saiful Anwar Hospital Malang, Dr. Soebandi Hospital Jember, and Dr. Iskak Hospital Tulungagung, between 1 June and 31 December 2023. A total of 161 eligible AMI subjects were randomly allocated 1:1 to colchicine (0.5 mg daily) or standard treatment for 30 days. Caspase-1, TGF-β, and Galectin-3 were tested on day 1 and day 5 by ELISA, while NT-proBNP was tested on days 5 and 30. Transthoracic echocardiography was also performed on day 5 and day 30. Results: By day 30, no significant improvements in systolic–diastolic echocardiography parameters had been shown in the colchicine group. However, colchicine reduced the level of NT-proBNP on day 30 more than placebo (ΔNT-proBNP: −73.74 ± 87.53 vs. −75.75 ± 12.44 pg/mL; p < 0.001). Moreover, colchicine lowered the level of Caspase-1 expression on day 5 and the levels of TGF-β and Galectin-3 expression on day 1. Conclusions: Colchicine can reduce NT-proBNP, Caspase-1, TGF-β, and Galectin-3 expression significantly among AMI patients. Colchicine administration was capable of reducing post-AMI inflammation, ventricular dysfunction, and heart failure but did not improve systolic–diastolic echocardiography parameters (ClinicalTrials.gov identifier: NCT06426537). © 2025 by the authors.
Doctoral Program of Medical Science, Brawijaya University, Malang, 65145, Indonesia; Department of Cardiology and Vascular Medicine, Dr. Iskak General Hospital, Tulungagung, 66223, Indonesia; Department of Cardiology and Cardiovascular Medicine, Faculty of Medicine, Brawijaya University, Dr. Saiful Anwar General Hospital, Malang, 65145, Indonesia; Cardiovascular Research Centre, Universitas Brawijaya, Malang, 65145, Indonesia; Department of Nursing Science, Faculty of Medicine, Brawijaya University, Malang, 65145, Indonesia; Department of Biochemistry, Faculty of Medicine, Brawijaya University, Malang, 65145, Indonesia; Department of Parasitology, Faculty of Medicine, Brawijaya University, Malang, 65145, Indonesia; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Brawijaya University, Dr. Saiful Anwar General Hospital, Malang, 65145, Indonesia; Division of Cardiovascular Science, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, M13, Manchester, 9PT, United Kingdom; Department of Pharmacology, Faculty of Medicine, Brawijaya University, Malang, 65145, Indonesia; Department of Pharmacy, Faculty of Medicine, Brawijaya University, Malang, 65145, Indonesia; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, 60286, Indonesia
