Patients with colorectal cancer (CRC) are 2-4 times more likely to develop cardiovascular disease, as compared to individuals without a history of cancer. With survival rates increasing significantly over the last 4 decades, this has important implications in patients that are now more susceptible to competing causes of morbidity and mortality, including cardiovascular disease. In this retrospective cohort study, 2839 patients with CRC treated with curative intent were followed up to quantify the incidence of cardiovascular events up to 10 years after CRC diagnosis (2006-2011), and determine which measures of body composition are associated with major adverse cardiovascular events (MACEs) in patients with CRC. Researchers found that the cumulative incidence of MACE 10 years after CRC diagnosis was 19.1%. Of note, a considerable number of patients were former (40%) or current smokers (12%), had hypertension (55%), hyperlipidemia (49%) and type 2 diabetes (20%). Body mass index (BMI) was not correlated with MACE; however, researchers found that visceral adipose tissue area was associated with MACE, where in contrasting the highest and lowest quintiles, HR was 1.54 (95% CI 1.02 to 2.31, p=0.04). Subcutaneous adipose tissue area was not associated with MACE (p=0.92). Contrasting the highest (i.e. less lipid stored in the muscle) to lowest quintile of muscle radiodensity, the multivariable-adjusted cause-specific HR for MACE was 0.67 (95% CI, 0.44 to 1.03, p=0.02 for trend). This study therefore shows that visceral adiposity and muscle radiodensity may be risk factors for MACE in patients previously diagnosed with CRC. The results of this study also indicated that BMI likely has limited utility in determining cardiovascular risk in this patient population.
Click to read the study in JAMA Oncology
Image: PD
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