Colchicine in Patients at Cardiac Risk Undergoing Major Non-Cardiac Surgery

Inclusion Criteria: undergoing major non-cardiac surgery in general anaesthesia will be included. Major non-cardiac surgery is defined as: * vascular surgery (with the exception of arteriovenous shunt, vein stripping procedures and carotid endarterectomies) * intraperitoneal surgery * intrathoracic surgery * major orthopaedic surgery (spinal surgery or joint replacement surgery) * at cardiovascular risk, defined as meeting at least 1 of the following 6 criteria: * preoperative n-terminal pro brain natriuretic peptide (NT-proBNP) ≥ 200 ng/l * history of coronary artery disease * history of peripheral vascular disease * history of stroke * undergoing major vascular surgery, with the exception of arteriovenous shunt, vein stripping procedures and carotid endarterectomies * fulfilment of any 3 of the 8 following criteria: * undergoing major surgery (intrathoracic, intraperitoneal or supra-inguinal vascular surgery) * any history of congestive heart failure or history of pulmonary oedema * anamnestic transient ischemic attack (TIA) * diabetes under treatment with either oral antidiabetic agent or insulin * age \> 70 years * history of hypertension * serum creatinine \> 175 mumol/l or calculated creatinine clearance \< 60 ml/min/1.73m2 (cockcroft gault) * history of smoking within 2 years of surgery * planned surgical time ≥ 90 minutes * planned postoperative hospital stay at least 1 night Exclusion Criteria: * no written consent * inclusion in other clinical trial with direct impact on perioperative medication * previously reported side effects or reported intolerance from colchicine (e.g., allergic reaction or significant sensitivity to colchicine or an auxiliary substance of the IMP) * pregnancy or planned pregnancy and/or breast feeding * clinically significant history of drug or alcohol abuse within the last year * very severe frailty (≥ 8 clinical frailty scale) * patient with inflammatory bowel disease (e.g., Morbus Crohn or Colitis ulcerosa) * patient taking colchicine for other indications (e.g., familial Mediterranean fever, gout) * severe renal impairment (eGFR \< 30 ml min -1 1.73 m2 -1) or end-stage renal disease with indication for haemodialysis * history of solid organ or bone marrow transplantation * systemic immune-suppression (medication (steroids \>30mg cortisol-equivalent per day, tacrolimus etc...) or disease (e.g., myelodysplastic syndrome) * severe hepatic impairment with history of cirrhosis * chronic active hepatitis or functional disorders defined as alanine aminotransferase greater than three times the upper limit of normal * anticipated post-operative administration of CYP3A4 metabolized substances like cyclosporine, ketoconazole, clarithromycin, verapamil, quinidine, diltiazem or ritonavir * Any other condition that the investigator would consider a risk to the patient if the latter were to participate in the study.