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In the pathogenesis of atherosclerosis, inflammation assumes a pivotal role, not solely in the initiation and complications of atherosclerotic plaque formation, but also in the myocardial response to ischemic insult. Acute inflammatory processes, coupled with time to reperfusion, orchestrate ischemic and reperfusion injuries, dictating infarct magnitude and acute left ventricular (LV) remodeling. Conversely, chronic inflammation, alongside neurohumoral activation, governs persistent LV remodeling. The interplay between chronic LV remodeling and recurrent ischemic episodes delineates the progression of the disease toward heart failure and cardiovascular death. Colchicine exerts anti-inflammatory properties affecting both the myocardium and atherosclerotic plaque by modulating the activity of monocyte\/macrophages, neutrophils, and platelets. This modulation can potentially result in a more favorable LV remodeling and forestalls the recurrence of ACS. This narrative review aims to delineate the role of inflammation across the different phases of ACS pathophysiology and describe the mechanistic underpinnings of colchicine, exploring its purported role in modulating each of these stages.<\/jats:p>","DOI":"10.3389\/fcvm.2024.1356023","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T04:52:05Z","timestamp":1719463925000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":31,"title":["Role of inflammation and evidence for the use of colchicine in patients with acute coronary syndrome"],"prefix":"10.3389","volume":"11","author":[{"given":"Juan Francisco","family":"Bulnes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Vel\u00e1squez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Paz","family":"Orellana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Mu\u00f1oz","family":"Venturelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1016\/S0140-6736(18)32203-7","article-title":"Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the global burden of disease study 2017","volume":"392","year":"2018","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1161\/CIRCULATIONAHA.115.016021","article-title":"Estimates of global and regional premature cardiovascular mortality in 2025","volume":"132","author":"Roth","year":"2015","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990\u20132019: update from the GBD 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e618","DOI":"10.1161\/CIR.0000000000000617","article-title":"Fourth universal definition of myocardial infarction (2018)","volume":"138","author":"Thygesen","year":"2018","journal-title":"Circulation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1016\/S0140-6736(21)02391-6","article-title":"Acute coronary syndromes","volume":"399","author":"Bergmark","year":"2022","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1016\/j.amjcard.2017.12.037","article-title":"Recurrent cardiovascular events in survivors of myocardial infarction with ST-segment elevation (from the AMI-QUEBEC study)","volume":"121","author":"Huynh","year":"2018","journal-title":"Am J Cardiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1056\/NEJMoa1002358","article-title":"A prospective natural-history study of coronary atherosclerosis","volume":"364","author":"Stone","year":"2011","journal-title":"N Engl J Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1080\/07853890.2020.1775287","article-title":"Lipoprotein(a) in atherosclerosis: from pathophysiology to clinical relevance and treatment options","volume":"52","author":"Rehberger Likozar","year":"2020","journal-title":"Ann Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.acvd.2020.11.006","article-title":"Triglycerides and risk of atherosclerotic cardiovascular disease: an update","volume":"114","author":"Farnier","year":"2021","journal-title":"Arch Cardiovasc Dis"},{"key":"B10","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1002\/clc.22110","article-title":"Cholesterol levels and the association of statins with in-hospital mortality of myocardial infarction patients insights from a Chilean registry of myocardial infarction","volume":"36","author":"Martinez","year":"2013","journal-title":"Clin Cardiol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1177\/2047487319848214","article-title":"HDL: fact, fiction, or function? 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