Cardiovascular events after elective colorectal cancer surgery in patients with stage I-III disease with no previous cardiovascular disease
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Cardiovascular events after elective colorectal cancer surgery in patients with stage I-III disease with no previous cardiovascular disease. / Degett, Thea Helene; Moustsen-Helms, Ida Rask; Larsen, Signe Benzon; Kjær, Trille Kristina; Tjønneland, Anne; Kjær, Susanne Krüger; Johansen, Christoffer; Gögenur, Ismail; Dalton, Susanne Oksbjerg.
In: Acta Oncologica, Vol. 62, No. 7, 2023, p. 728-736 .Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Cardiovascular events after elective colorectal cancer surgery in patients with stage I-III disease with no previous cardiovascular disease
AU - Degett, Thea Helene
AU - Moustsen-Helms, Ida Rask
AU - Larsen, Signe Benzon
AU - Kjær, Trille Kristina
AU - Tjønneland, Anne
AU - Kjær, Susanne Krüger
AU - Johansen, Christoffer
AU - Gögenur, Ismail
AU - Dalton, Susanne Oksbjerg
N1 - Publisher Copyright: © 2023 Acta Oncologica Foundation.
PY - 2023
Y1 - 2023
N2 - Background: The risk of cardiovascular events in patients treated for colorectal cancer is debated due to diverging results in previous studies. Colorectal cancer and cardiovascular disease share several risk factors such as physical inactivity, obesity, and smoking. Information about confounding covariates and follow-up time are therefore essential to address the issue. This study aims to investigate the risk of new-onset cardiovascular events for patients with stage I-III colorectal cancer receiving elective surgery compared to a matched population. Material and Methods: Using a prospective cohort, we compared cardiovascular events among 876 patients treated with elective surgery for incident stage I-III colorectal cancer diagnosed between January 1st, 2001 and December 31st, 2016 to a cancer-free cohort matched by age, sex, and time since enrollment (N = 3504). Regression analyses were adjusted for lifestyle, cardiovascular risk factors, and comorbidity. Multivariable analyses were used to identify risk factors associated with cardiovascular events in the postoperative (<90 days of elective surgery) and long-term phase (>90 days after elective surgery). Results: After a median follow-up of 3.9 years, the hazard ratio (HR) for incident heart failure was 1.53 (95% CI 1.02–2.28) among patients operated for colorectal cancer. The postoperative risk of myocardial infarction or angina pectoris was associated with the use of lipid-lowering drugs. Long-term risks of cardiovascular events were ASA-score of III+IV and lipid-lowering drugs with HRs ranging from 2.20 to 15.8. Further, the use of antihypertensive drugs was associated with an HR of 2.09 (95% CI 1.06–4.13) for angina pectoris or acute myocardial infarction. Heart failure was associated with being overweight, diabetes, and anastomosis leakage. Conclusion: We observed an increased hazard of heart failure in patients operated on for stage I-III colorectal cancer compared to cancer-free comparisons. We identified several potential risk factors for cardiovascular events within and beyond 90 days of elective surgery.
AB - Background: The risk of cardiovascular events in patients treated for colorectal cancer is debated due to diverging results in previous studies. Colorectal cancer and cardiovascular disease share several risk factors such as physical inactivity, obesity, and smoking. Information about confounding covariates and follow-up time are therefore essential to address the issue. This study aims to investigate the risk of new-onset cardiovascular events for patients with stage I-III colorectal cancer receiving elective surgery compared to a matched population. Material and Methods: Using a prospective cohort, we compared cardiovascular events among 876 patients treated with elective surgery for incident stage I-III colorectal cancer diagnosed between January 1st, 2001 and December 31st, 2016 to a cancer-free cohort matched by age, sex, and time since enrollment (N = 3504). Regression analyses were adjusted for lifestyle, cardiovascular risk factors, and comorbidity. Multivariable analyses were used to identify risk factors associated with cardiovascular events in the postoperative (<90 days of elective surgery) and long-term phase (>90 days after elective surgery). Results: After a median follow-up of 3.9 years, the hazard ratio (HR) for incident heart failure was 1.53 (95% CI 1.02–2.28) among patients operated for colorectal cancer. The postoperative risk of myocardial infarction or angina pectoris was associated with the use of lipid-lowering drugs. Long-term risks of cardiovascular events were ASA-score of III+IV and lipid-lowering drugs with HRs ranging from 2.20 to 15.8. Further, the use of antihypertensive drugs was associated with an HR of 2.09 (95% CI 1.06–4.13) for angina pectoris or acute myocardial infarction. Heart failure was associated with being overweight, diabetes, and anastomosis leakage. Conclusion: We observed an increased hazard of heart failure in patients operated on for stage I-III colorectal cancer compared to cancer-free comparisons. We identified several potential risk factors for cardiovascular events within and beyond 90 days of elective surgery.
KW - cardiovascular disease
KW - Colorectal cancer
KW - late effects
KW - surgery
U2 - 10.1080/0284186X.2023.2212844
DO - 10.1080/0284186X.2023.2212844
M3 - Journal article
C2 - 37262420
AN - SCOPUS:85161377040
VL - 62
SP - 728
EP - 736
JO - Acta Oncologica
JF - Acta Oncologica
SN - 1100-1704
IS - 7
ER -
ID: 356769781