Acute coronary syndrome (ACS) a spectrum of conditions resulting from the rupture of atherosclerotic plaques and subsequent thrombosis. Inflammation is a critical component in the pathogenesis of ACS. Elevated levels of high sensitivity C-reactive protein (hs-CRP), Neutrophil levels and Neutrophil-to-Lymphocyte ratio (NLR) have been associated with poorer outcome, suggesting that targeting inflammation may improve clinical results. Colchicine has been shown potential benefits in reducing inflammatory markers in cardiovascular events and hs-CRP level. However, currents clinical guidelines have not yet established colchicine as a standard treatment in ACS undergoing PCI. 

A single-center, retro-prospective observational cohort study conducted at Rajavithi between 1 January 2024 to 31 December 2024. Enrolled ACS patients who have undergone PCI within 45 days of diagnosis. Patients receiving colchicine 0.6 mg per day as part of their treatment will be compared to a control group receiving standard care. Hs-CRP levels will be measured at baseline, 1 and 3 months, alongside monitoring clinical outcomes and other relevant variables. 

Total 56 patients were enrolled. The observational reduction in hs-CRP levels (2.29±3.37 vs. 0.45±1.03, p=0.044) indicates that colchicine effectively reduces inflammation in this patient population. Similarly, Neutrophil counts and Neutrophil-Lymphocyte ratio (NLR) showed a significant reduction in the colchicine group compared to the non-colchicine group 21.86±10.62 vs. 4.13±12.92, p=0.001 and 2.98±2.93 vs. 1.68±3.60, p=0.025 respectively. There were no significant differences in MACE. 

Colchicine significantly reduces hs-CRP, neutrophil levels and NLR in patients with acute coronary syndrome undergoing PCI. NLR levels are positively correlated with hs-CRP level and the severity of ACS, and can be used as a predictor of the inflammatory marker of ACS patients. These findings highlight colchicine's potential to modulate systemic inflammation and its possible cardioprotective benefits. However, the absence of significant differences in clinical outcomes such as mortality and stroke may be attributed to the study's limited sample size and short follow-up duration.