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 28 May 2018

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Increased risk of colorectal neoplasms with coronary artery disease

This week's Journal of the American Medical Association assesses the prevalence of colorectal neoplasm in newly diagnosed coronary artery disease.

News image

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Colorectal neoplasm and coronary artery disease (CAD) share similar risk factors, and their co-occurrence may be associated.

Dr Annie On On Chan and colleagues from China investigated the prevalence of colorectal neoplasm in patients with coronary artery disease in a cross-sectional study.

The research team identified the predisposing factors for the association of the 2 diseases.

The team recruited 206 patients in Hong Kong for screening colonoscopy after undergoing coronary angiography for suspected coronary artery disease between 2004 and 2006.

34% of coronary artery disease-positive patients had colorectal neoplasm
Journal of the American Medical Association

Presence of coronary artery disease was defined as at least 50% diameter stenosis in any 1 of the major coronary arteries.

The team reported that 208 patients were considered coronary artery disease-negative.

The team recruited 207 age- and sex-matched controls from the general population.

Patients were excluded for use of aspirin or statins, personal history of colonic disease, or colonoscopy in the past 10 years.

The researchers found that the prevalence of colorectal neoplasm in the coronary artery disease-positive patients was 34%.

The prevalence in coronary artery disease-negative patients, and the general population groups was 19% and 21%, respectively.

The prevalence of advanced lesions was 18%, 9%, and 6% for coronary artery disease-positive, and coronary artery disease-negative patients, and the general population group, respectively.

The prevalence of cancer was 4%, 1%, and 1% in coronary artery disease-positive, coronary artery disease-negative patients, and the general population, respectively.

The team found 50% of the cancers in coronary artery disease-positive participants were early stage.

After adjusting for age and sex, the researchers observed an association between colorectal neoplasm and presence of coronary artery disease.

In addition, the team noted an association between advanced lesions and presence of coronary artery disease.

The metabolic syndrome, and history of smoking were independent factors for the association of advanced colonic lesions and coronary artery disease.

Dr On On Chan's team concluded, "In this study population undergoing coronary angiography, the prevalence of colorectal neoplasm was greater in patients with coronary artery disease."

"The association between the presence of advanced colonic lesions and coronary artery disease was stronger in persons with the metabolic syndrome and a history of smoking."

JAMA 2007: 298(12): 1412-9
27 September 2007

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