Low-dose Colchicine for CABG Graft Failure Prevention

• Colchicine Pill (Drug), also known as Colchicine 0.5 MG: Colchicine 0.5 mg once daily will be given on the basis of guideline-recommended standard secondary prevention therapy after CABG for 24 months.
• Placebo (Drug): Placebo one tablet once daily will be given on the basis of guideline-recommended standard secondary prevention therapy after CABG for 24 months.

Primary outcomes

• graft failure rate [2 year after randomization]: At 24 months postoperatively, all patients who complete the study will undergo coronary computed tomographic angiography (CCTA) to assess graft patency, calculated as 1 minus graft failure rate, where graft failure rate = (number of grafts graded B or O according to the Fitzgibbon classification / total number of grafts) × 100%.

Secondary outcomes

• MACCE [2 year after randomization]: Major adverse cardiovascular and cerebrovascular events include cardiovascular death, non-fatal ischemic stroke, non-fatal spontaneous (non-operating-related) myocardial infarction, readmission for acute coronary syndrome, and Coronary revascularization

Sex: All, ages: 18 Years to any

Inclusion Criteria:

1. Be male or female, aged 18 years or older;
2. Within 3 days after successful isolated coronary artery bypass grafting (CABG);
3. Sign informed consent;

Exclusion Criteria:

1. Severe valvular heart disease requiring concomitant or staged valvular surgery;
2. History of non-skin cancer in the past 3 years;
3. Inflammatory bowel disease or chronic diarrhea;
4. Neuromuscular diseases or non-transient creatine kinase levels greater than 3 times the upper limit of the normal range (except those associated with myocardial infarction);
5. Clinically significant non-transient (At least 2 laboratory tests) blood abnormalities (Hemoglobin <100g/L or hematocrit < 30% or > 52% or white blood cell count < 3×109/L or platelet count < 100×109/L);
6. Estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m² (based on the CKDEPI formula);
7. Serum alanine aminotransferase and/or aspartate aminotransferase levels greater than 2 times the upper limit of the normal range, accompanied by serum total bilirubin levels greater than 2 times the upper limit of the normal range or severe liver disease with coagulation disorders (INR>1.5) (except for elevated glutamic oxalacetic transaminase associated with myocardial infarction);
8. Decline in cognitive function due to inability to perform basic activities of daily living independently;
9. Drug or alcohol abuse;
10. Other immunosuppressive therapies already in existence or planned;
11. Other causes require long-term colchicine treatment;
12. History of clear or suspected colchicine allergy;
13. Strong CYP3A4 or P-glycoprotein inhibitors (such as cyclosporine, antiretrovirals, antifungals, erythromycin and clarithromycin) have been used and no other alternative drugs can be used.