Does Combination Therapy With SGLT2 Inhibitors and Colchicine Reduce Mortality and Cardiovascular Events in Coronary Artery Disease?

A real-world data analysis found that among patients with coronary artery disease (CAD), combination therapy with sodium-glucose cotransporter 2 inhibitors (SGLT2i) and colchicine was associated with significantly lower risks of all-cause mortality, major adverse cardiovascular events (MACE), ischemic stroke, and atrial fibrillation (AF) compared with colchicine monotherapy.

This study aimed to explore the potential additive benefits of combining these two agents in routine clinical practice to reduce cardiovascular morbidity and mortality.

Using the TriNetX Global Collaborative Network database, researchers retrospectively identified adults aged 18 years or older with CAD between January 2015 and August 2023. Patients were divided into two cohorts: one receiving both colchicine and an SGLT2 inhibitor, and a control group receiving colchicine alone. Propensity score matching (PSM) was performed 1:1 to balance baseline characteristics, resulting in 17,282 patients in each group. Outcomes were assessed over a 1-year follow-up period. Following PSM, the mean age of the cohort was 68.6 years.

Combination therapy was associated with significantly improved outcomes in key endpoints: reduced all-cause mortality, MACE, ischemic stroke, and AF. The relative risk (RR) reductions were most notable for all-cause mortality (RR, 0.63; 95% CI, 0.58-0.67; P < .01), with modest but statistically significant reductions in MACE (RR, 0.86; 95% CI, 0.78-0.96; P  < .01), ischemic stroke (RR, 0.79; 95% CI, 0.68-0.93; P  < .01), and AF (RR, 0.87; 95% CI, 0.78-0.98; P  = .02).

There were no statistically significant differences between groups in the risk of heart failure or hemorrhagic stroke.

“This study suggests that SGLT2i use along with colchicine was associated with significantly lower risk of mortality, MACE, ischemic stroke, and AF among CAD patients in comparison to colchicine alone,” the authors concluded.

Reference
Jaiswal V, Hanif M, Jaiswal A, et al. Efficacy of sodium-glucose cotransporter 2 inhibitors along with colchicine versus colchicine alone among coronary artery disease patients. Paper presented at: American College of Cardiology; March 29-31, 2025; Chicago, IL. Accessed March 23, 2025. https://accscientificsession.acc.org/