Colchicine in the Spotlight at ESC 2026: Why, for Whom, and for How Long?

This article summarizes the key data on the use of colchicine in cardiology presented at ESC Congress 2026 in Munich. It discusses the role of residual inflammation in the progression of atherosclerotic cardiovascular disease and the mechanisms underlying the anti-inflammatory effects of colchicine. The key findings of the COLCOT and LoDoCo2 randomized controlled trials and a meta-analysis of six RCTs are presented, demonstrating that low-dose colchicine reduces the risk of recurrent non-fatal ischemic events in patients with established atherosclerotic cardiovascular disease. The article outlines the ESC recommendations for colchicine use in chronic coronary syndrome, acute and recurrent pericarditis, myopericarditis, and the prevention of post-pericardiotomy syndrome. It also reviews new evidence regarding the potential plaque-stabilizing effects of colchicine, the rationale for its combination with statins, and the safety of long-term therapy. Patient groups most likely to benefit from colchicine are identified, along with recommended doses and treatment duration; its clinical benefits and prospects for improving the availability of low-dose colchicine (Colchanova) in Ukraine are also discussed.

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