Cardiovascular Risk and Known Coronary Artery Disease Are Associated With Colorectal Adenoma and Advanced Neoplasia

Niederseer, David; Stadlmayr, Andreas; Huber-Schönauer, Ursula; Plöderl, Martin; Schmied, Christian; Lederer, Dieter; Patsch, Wolfgang; Aigner, Elmar; Datz, Christian

doi:10.1016/j.jacc.2017.02.065

Cited by 16 publications

(23 citation statements)

References 3 publications

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“…Subjects with known CAD history and high cardiovascular risk profiles had a higher probability of colorectal neoplasia, as reported previously, see Figure 1, Table 2, Table 3 and Table 4 [22].…”

Section: Resultssupporting

confidence: 79%

“…Emerging evidence suggests an association between coronary artery disease (CAD) and CRC, possibly due to the shared risk factors, such as obesity, sedentary lifestyle, diabetes mellitus, hypertension, and cigarette smoking [15,16,17,18,19,20,21]. In a recently published study we showed that colorectal cancer was associated with cardiovascular risk factors in a large Caucasian cohort [22]. To the best of our knowledge, we are not aware of studies investigating if the associations between cardiovascular risk factors differ between the different sites of colorectal neoplasias, in screening colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

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Association between Cardiovascular Risk and Diabetes with Colorectal Neoplasia: A Site-Specific Analysis

Niederseer

Bracher

Stadlmayr

et al. 2018

JCM

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Several studies have shown site-specific differences in colorectal cancer (CRC) with respect to the risk factors. CRC was shown to be associated with cardiovascular risk (CVR) factors, but site-specific variations have not been investigated so far. This study aimed to assess the associations between the prevalence and subsite-specific differences of colorectal neoplasia and established CVR scores or known coronary artery disease (CAD) in a large asymptomatic European screening cohort (N = 2098). Participants underwent simultaneous screening colonoscopy and CVR evaluation, using the Framingham Risk Score and Heart Score. Lesions found in the colonoscopy were classified by location (proximal/distal colon or rectum). More neoplasias were found in the proximal versus the distal colon (p < 0.001). The Framingham Risk Score and Heart Score showed incremental risk for colorectal adenoma, across the tertiles in the proximal and the distal colon (p < 0.001). The prevalence of adenomas in the rectum was much lower, but also here, incremental risk could be shown for the Framingham Risk but not the Heart Risk Score tertiles. Prevalence of adenomas in the proximal colon was higher in subjects with type 2 diabetes (T2DM) (p = 0.006), but no association was found between adenomas and T2DM in the distal colon (p = 0.618) and the rectum (p = 0.071). Males had a higher CVR and more findings, in the screening colonoscopy, as compared to females, however, no site-specific differences were noted. Patients with known CAD and high CVR have an increased risk of colorectal neoplasia in both the proximal and distal colon. Patients with T2DM have a higher risk for neoplasia in the proximal colon.

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Section: Resultssupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Association between Cardiovascular Risk and Diabetes with Colorectal Neoplasia: A Site-Specific Analysis

Niederseer

Bracher

Stadlmayr

et al. 2018

JCM

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“…4 Studies have reported an association between colorectal neoplasia and CAD, especially right-sided colon cancer (RCC). 5,6 This patient, who did not have any major cardiovascular (CV) risk factors, was found to have a coassociation between RCC and CTO of LMCA.…”

Section: Discussionmentioning

confidence: 92%

Double Trouble: A Rare Association between Chronic Total Occlusion of the Left Main Coronary Artery and Colonic Malignancy

Sarojadevi

Arasappa

Eugin

et al. 2020

Journal of Health and Allied Sciences NU

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Emerging evidence has shown an association between cardiovascular (CV) disease and cancer due to shared risk factors and biological mechanisms especially chronic inflammation. The objective of this case report is to highlight the association between these two lethal diseases and the challenges in the management of coronary artery disease in patients with coexisting malignancy.A 65-year-old nonsmoker, nondiabetic, and normotensive male presented with a history of abdominal pain and significant weight loss. Colonoscopy and biopsy showed adenocarcinoma of the ascending colon, and he was planned for right hemicolectomy. Electrocardiogram exercise stress test performed as a part of preoperative evaluation was strongly positive. Coronary angiography was suggestive of Chronic total occlusion of the left main coronary artery. Though the syntax score was intermediate, coronary artery bypass grafting was decided as the revascularization strategy as he needed early surgery for the colonic malignancy. A month later, he underwent right hemicolectomy.Clinicians should be aware of the association between CV disease and cancer as they are likely to face similar situations where both coexist. Understanding the connections between heart disease and cancer will help to formulate combined preventive guidelines.

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“…However, whether HER2 plays a role in other pathological mechanisms underlying CAD remains to be defined. Emerging evidences suggest a close relationship between CAD and cancer, which is attributed to shared risk factors such as obesity, diabetes, hypertension, and dyslipidemia [26,27]. However, CAD and cancer may also overlap with some potential biological pathways which have not been fully understood.…”

Section: Discussionmentioning

confidence: 99%

Association between serum HER2/ErbB2 levels and coronary artery disease: a case–control study

et al. 2020

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Background: Research has associated human epidermal growth factor receptor (HER2) with glucose and lipid metabolism. However, the association between circulating HER2 levels and coronary artery disease (CAD) remains to be elucidated. Methods: We performed a case-control study with 435 participants (237 CAD patients and 198 controls) who underwent diagnostic coronary angiography from September 2018 to October 2019. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for CAD were calculated with multiple logistic regression models after adjustment for confounders. Results: Overall, increased serum HER2 levels were independently associated with the presence of CAD (OR per 1-standard deviation (SD) increase: 1.438, 95% CI 1.13-1.83; P = 0.003) and the number of stenotic vessels (OR per 1-SD increase: 1.399, 95% CI 1.15-1.71; P = 0.001). In the subgroup analysis, a significant interaction of HER2 with body mass index (BMI) on the presence of CAD was observed (adjusted interaction P = 0.046). Increased serum HER2 levels were strongly associated with the presence of CAD in participants with BMI ≥ 25 kg/m 2 (OR per 1-SD increase: 2.143, 95% CI 1.37-3.35; P = 0.001), whereas no significant association was found in participants with BMI < 25 kg/m 2 (OR per 1-SD increase: 1.225, 95% CI 0.90-1.67; P = 0.201). Conclusion: Elevated HER2 level is associated with an increased risk of CAD, particularly in people with obesity. This finding yields new insight into the pathological mechanisms underlying CAD, and warrants further research regarding HER2 as a preventive and therapeutic target of CAD.

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Cardiovascular Risk and Known Coronary Artery Disease Are Associated With Colorectal Adenoma and Advanced Neoplasia

Cited by 16 publications

References 3 publications

Association between Cardiovascular Risk and Diabetes with Colorectal Neoplasia: A Site-Specific Analysis

Association between Cardiovascular Risk and Diabetes with Colorectal Neoplasia: A Site-Specific Analysis

Double Trouble: A Rare Association between Chronic Total Occlusion of the Left Main Coronary Artery and Colonic Malignancy

Association between serum HER2/ErbB2 levels and coronary artery disease: a case–control study

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