---
title: "Low-dose colchicine and coronary microcalcification after CABG in diffuse CAD: COL-CABG trial prot"
id: "bmj-open-9-influence-of-low-dose-colchicine-on-coronary-microcalcification-activity-in"
canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-9-influence-of-low-dose-colchicine-on-coronary-microcalcification-activity-in"
content_type: "clinical_feed_article"
specialty: "Cardiology"
source_name: "BMJ Open"
source_url: "http://bmjopen.bmj.com/cgi/content/short/16/9/e117294?rss=1"
published_at: "2026-09-15T12:32:32.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Low-dose colchicine and coronary microcalcification after CABG in diffuse CAD: COL-CABG trial prot
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-9-influence-of-low-dose-colchicine-on-coronary-microcalcification-activity-in
- **Specialty:** [Cardiology](https://medichelpline.com/clinical-feed/cardiology.md)
- **Primary Source:** BMJ Open
- **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/9/e117294?rss=1)
- **Published At:** 2026-09-15T12:32:32.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- The COL-CABG trial is a single-centre, prospective, randomised, open-label, blinded-endpoint study at Beijing Anzhen Hospital assessing whether **low-dose colchicine** (0.5 mg/day) modifies coronary microcalcification activity measured by **18F-NaF** uptake in patients with **diffuse coronary artery disease (DCAD)** undergoing coronary artery bypass grafting (**CABG**). - The trial will enrol 108 patients with DCAD who have a tissue-to-background ratio (**TBR**) > 3.6 on baseline 18F-NaF imaging; recruitment is planned from July 2026 to June 2028. - Participants will be randomised 1:1 to a colchicine group versus control (standard care) and all will undergo CABG. - The primary endpoint is the change in coronary microcalcification activity (TBR at baseline minus TBR at 90 days post-CABG) to assess short-term effects on plaque microcalcification. - Secondary clinical outcomes are perioperative myocardial infarction (PMI) within 7 days after CABG and major adverse cardiovascular and cerebrovascular events (**MACCEs**) within 90 days; MACCEs are defined as all-cause death, cardiogenic shock, spontaneous myocardial infarction after postoperative day 7, stroke, and repeat coronary revascularisation. - The trial treats secondary clinical outcomes as exploratory and hypothesis-generating rather than definitive. - The protocol references the 2024 European Society of Cardiology guidance that recommends low-dose colchicine in chronic coronary syndromes alongside statins and standard secondary prevention to prevent MACCEs; the mechanism by which colchicine may improve plaque stability and reduce events is uncertain and under investigation. - Ethics approval has been granted by the Institutional Review Board of Beijing Anzhen Hospital (approval number: 2025202x). Written informed consent will be obtained, and results will be disseminated via peer-reviewed publications and scientific meetings. - Trial registration: ChiCTR2500111659.
## Clinical Analysis & Structured Key Points
Introduction Coronary artery bypass grafting (CABG) is the main method to improve myocardial ischaemia in patients with complex coronary artery stenosis. Whereas, patients with diffuse coronary artery disease (DCAD) have a high incidence of perioperative myocardial infarction (PMI) and long-term major adverse cardiovascular and cerebrovascular events (MACCEs) after CABG. The coronary microcalcification activity reflected by sodium [ 18 F]fluoride ( 18 F-NaF) uptake has strong predictive value for the adverse events indication after CABG, which is closely related to the coronary immunoinflammatory microenvironment. Low-dose colchicine (0.5 mg/day) was recommended by the 2024 European Society of Cardiology (ESC) guidelines for the management of chronic coronary syndromes, to be administered except statins and standard secondary prevention therapies, for the prevention of MACCEs. The effectiveness of low-dose colchicine is considered to enhance coronary plaque stability and reduce adverse events, but the mechanism is unclear. Therefore, the aim of this trial is to evaluate the effects of low-dose colchicine on coronary microcalcification activity and the incidence of MACCEs in patients with DCAD undergoing CABG. Methods and analysis The COL-CABG trial is a single-centre, prospective, randomised, open-label, blinded-endpoint trial conducted at Beijing Anzhen Hospital, Capital Medical University. The study will prospectively enrol 108 DCAD patients with a tissue-to-background ratio (TBR) >3.6 at Beijing Anzhen Hospital from July 2026 to June 2028, and all patients are planned to undergo CABG. The patients will be randomly assigned (1:1) to (1) the colchicine group and (2) the control group. The primary endpoint is defined as the changes in coronary microcalcification activity (TBR=TBR (baseline) - TBR (90 days)) at 90 days after CABG in comparison with pre-CABG. Secondary clinical outcomes include PMI within 7 days after CABG and MACCEs within 90 days after CABG. MACCEs include all-cause death, cardiogenic shock, spontaneous myocardial infarction occurring after postoperative day 7, stroke and repeat coronary revascularisation. These clinical outcomes will be interpreted as exploratory and hypothesis-generating. Ethics and dissemination This study has been approved by the Institutional Review Board of Beijing Anzhen Hospital, Capital Medical University (approval number: 2025202x). Written informed consent will be obtained from all participants. The results will be disseminated through peer-reviewed publications and scientific conference presentations. Trial registration number ChiCTR2500111659.
## Related Clinical Research

- [Retinal changes on OCT may predict atrial fibrillation risk years before diagnosis](https://medichelpline.com/clinical-feed/medical-news-today-0-how-changes-in-the-eyes-may-help-spot-afib-risk-years-early.md)
- [Dyslipidemia care in Japan before and after the 2024 fee revision: nationwide claims analysis](https://medichelpline.com/clinical-feed/plos-one-19-real-world-patterns-of-dyslipidemia-care-before-and-after-a-national-fee.md)
- [Rotating Night Shift Work and Cardiovascular Disease and Mortality Risk by Chronotype in Nurses' H](https://medichelpline.com/clinical-feed/medrxiv-9-rotating-night-shift-work-and-risk-of-incident-cardiovascular-disease-and.md)
- [Registry vs Adjudicated Cardiovascular Events in BETAMI‑DANBLOCK: Validation of National Registry](https://medichelpline.com/clinical-feed/pubmed-41934630.md) (DOI: 10.1093/ehjqcco/qcag055)
- [Bempedoic Acid Lowers Major Adverse Limb Events and Cardiovascular Events in Statin‑Intolerant Pat](https://medichelpline.com/clinical-feed/pubmed-42610264.md) (DOI: 10.1161/CIRCULATIONAHA.125.078469)

## Navigation
- [← Back to Cardiology Feed](https://medichelpline.com/clinical-feed/cardiology.md)
- [← All Clinical Specialties](https://medichelpline.com/clinical-feed.md)
## Medical & Regulatory Disclaimer

> [!CAUTION]
> MedicHelpline content is structured for research, educational, and professional discovery purposes. It does not constitute individual medical advice, clinical diagnosis, or treatment recommendations.
> Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.