RESUMEN

BACKGROUND: Cardiovascular disease is the major cause of mortality in the United States. Despite lifestyle modification and traditional risk factor control residual inflammatory risk remains an untreated concern. Colchicine is an oral, medication that has been used for gout, mediterranean fever and pericarditis for decades. In recent trials, colchicine has been shown to reduce major adverse cardiovascular events, however the mechanism of benefit remains unclear. The objective of the randomized, double-blind, placebo controlled EKSTROM trial is to evaluate the effects of colchicine 0.5mg/day on atherosclerotic plaque. METHODS: Eighty-four participants will be enrolled after obtaining informed consent and followed for 12 months. Eligible patients will be randomly assigned to colchicine 0.5mg/day or placebo in a 1:1 fashion as add-on to their standard of care. All participants will undergo coronary computed tomography angiography (CCTA) at baseline and at 12 months. RESULTS: As of November 2023, the study is 100% enrolled with an expected end of study by the second quarter of 2024. The primary endpoint is change in low attenuation plaque volume as measured by CCTA. Secondary endpoints include change in volume of different plaque types (including total atheroma volume, noncalcified plaque volume, dense calcified plaque volume, remodeling index), change in inflammatory markers (IL-6, IL-1ß, IL-18, hs-CRP), change in pericoronary adipose tissue attenuation, change in epicardial adipose tissue volume and attenuation and change in brachial flow mediated dilation. CONCLUSION: EKSTROM is the first randomized study to assess the effects of colchicine on plaque progression, pericoronary and epicardial fat. EKSTROM will provide important information on the mechanistic effects of colchicine on the cardiovascular system. TRIAL REGISTRATION: Registry: clinicaltrials.gov, Registration Number: NCT06342609 url: https://www. CLINICALTRIALS: gov/study/NCT06342609?term=EKSTROM&rank=1.

Asunto(s)

Colchicina , Enfermedad de la Arteria Coronaria , Progresión de la Enfermedad , Placa Aterosclerótica , Humanos , Colchicina/uso terapéutico , Colchicina/administración & dosificación , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Método Doble Ciego , Placa Aterosclerótica/tratamiento farmacológico , Angiografía por Tomografía Computarizada/métodos , Masculino , Femenino , Angiografía Coronaria/métodos , Persona de Mediana Edad

RESUMEN

In our rapidly evolving world, technology stands at the forefront, driving remarkable advancements across various sectors. One of the most notable changes is the use of Artificial Intelligence (AI) and robotics in healthcare, starting a revolution that has the power to change women's health all over the world. Developed nations are already witnessing the benefits. However, a significant portion of the global population in underdeveloped regions is lagging behind, resulting in a noticeable disparity. This is particularly evident in women's healthcare, an area already facing global inequities. As we witness a digital revolution, we examine the progressive steps taken in women's healthcare. AI and robotics are key to this transformation. The services range from using data to predict cancer trends to tailor-made medicine and technologies in reproduction. This editorial addresses the existing gaps and the digital divide, exploring the necessity for an inclusive approach in technology design and implementation to ensure equitable healthcare access.  Furthermore, it highlights the imperative role of multi-sectoral collaborations to foster innovation while mitigating risks. The clear goal is to build a future where all women, no matter where they live, can get good healthcare, helped by AI and robotics, bringing in a time of healthcare for all. It's crucial for everyone involved to come together to make a healthcare system that everyone can use, helping women everywhere with the help of new technology.