Estimating Risk of Cardiovascular Disease Among Long-Term Colorectal Cancer Survivors: A Nationwide Cohort Study

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Seogsong Jeong¹  Seulggie Choi¹  Sung Min Kim¹  Jooyoung Chang¹  Sang Min Park²  Joung Sik Son³  Gyeongsil Lee⁴  Kyae Hyung Kim⁴  Kyuwoong Kim⁵  Yoosun Cho⁶ 

[1] Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea;Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea;Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea;Department of Family Medicine, Korea University Guro Hospital, Seoul, South Korea;Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea;National Cancer Control Institute, National Cancer Center, Goyang-si, South Korea;Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea;

关键词: cancer survivors;    cardiovascular disease;    gastrointestinal cancer;    coronary heart disease;    stroke;   

DOI  :  10.3389/fcvm.2021.721107

 received in 2021-06-06, accepted in 2021-12-07,  发布年份 2022

来源: Frontiers

【 摘 要 】

BackgroundConcerns about a growing number of colorectal cancer survivors have emerged regarding cardiovascular disease (CVD) risks. However, there is not yet a predictive tool that can estimate CVD risk and support the management of healthcare as well as disease prevention in terms of CVD risk among long-term colorectal cancer survivors.AimTo develop predictive tools to estimate individualized overall and each subtype of CVD risk using a nationwide cohort in South Korea.Methods and ResultsA total of 4,709 newly diagnosed patients with colorectal cancer who survived at least 5 years in the National Health Insurance System were analyzed. Cox proportional hazard regression was used for the identification of independent risk factors for the derivation of predictive nomograms, which were validated in an independent cohort (n = 3,957). Age, fasting serum glucose, γ-glutamyl transpeptidase, Charlson comorbidity index, household income, body mass index, history of chemotherapy, cigarette smoking, and alcohol consumption were identified as independent risk factors for either overall CVD or each subtype of CVD subtype. Based on the identified independent risk factors, six independent nomograms for each CVD category were developed. Validation by an independent cohort demonstrated a good calibration with a median C-index of 0.687. According to the nomogram-derived median score, relative risks of 2.643, 1.821, 4.656, 2.629, 4.248, and 5.994 were found for overall CVD, ischemic heart disease, myocardial infarction, total stroke, ischemic stroke, and hemorrhage stroke in the validation cohort.ConclusionsThe predictive tools were developed with satisfactory accuracy. The derived nomograms may support the estimation of overall and individual CVD risk for long-term colorectal cancer survivors.

【 授权许可】

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Copyright © 2022 Jeong, Lee, Choi, Kim, Chang, Kim, Kim, Son, Cho and Park.