Abstract

Previous studies evaluating associations between resting heart rate (RHR) and cancer-related mortality/prognosis have yielded conflicting results. We investigated whether elevations in RHR are associated with colorectal cancer (CRC). We conducted a case-controlled study involving 1241 CRC patients and 5909 cancer-free controls from the Korean National Health and Nutrition Examination Survey. After propensity score (PS) matching, 1207 CRC patients and 1207 matched controls were analyzed. Associations between RHR and CRC, colon, and rectal cancer were analyzed in appropriate patient subgroups using multiple and conditional logistic regression. Receiver operating characteristics analysis yielded the optimal RHR cut-point to predict CRC. RHR was significantly higher in CRC, colon, and rectal cancer patients than in controls (72.7 bpm in CRC, 72.8 bpm in colon cancer, 72.3 bpm in rectal cancer, and 68.7 bpm in controls; all p < 0.001). Analysis of data prior to PS matching yielded the following odds ratios (ORs) per RHR increment for CRC, colon, and rectal cancer: 1.043 (95% confidence intervals (CIs): 1.036–1.049), 1.045 (95% CI: 1.037–1.053), and 1.040 (95% CI: 1.030–1.051), respectively, in unadjusted models, and 1.043 (95% CI: 1.034–1.051), 1.046 (95% CI: 1.037–1.055), and 1.040 (95% CI: 1.027–1.052), respectively, in multivariable adjusted models. Patients with CRC, colon, and rectal cancer have a significantly higher RHR compared to cancer-free controls.

Highlights

  • Colorectal cancer (CRC) is the third most-common cancer and second leading cause of cancer-related death in both sexes according to Global cancer statistics GLOCAN 2018 reports [1]

  • CRC and colon cancer patients had significantly higher white blood cell (WBC) counts (p < 0.001); resting heart rate (RHR) was significantly higher in CRC, colon, and rectal cancer patients than controls (72.7 bpm in CRC, 72.8 bpm in colon cancer, 72.3 bpm in rectal cancer, and 68.7 bpm in controls; all p < 0.001)

  • Cancer across each cut-off points (A) before propensity score matching and (B) after propensity score matching. In this case-controlled study, we found that patients with CRC, colon, and rectal cancer have a Inhigher this case-controlled study, we found that patients withamong

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Summary

Introduction

Colorectal cancer (CRC) is the third most-common cancer and second leading cause of cancer-related death in both sexes according to Global cancer statistics GLOCAN 2018 reports [1]. CRC is three times more prevalent in developed countries than in developing countries [1]. High resting heart rate (RHR) may reflect an underlying autonomic dysfunction and sympathetic overactivity [4]. This autonomic imbalance may contribute to increased subclinical inflammation, which has been known to be a central process in the initiation and progression of atherosclerosis [5,6,7,8,9,10].

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