40 55

Cited 0 times in

The association between progression of coronary artery calcium and colorectal adenoma: A retrospective follow-up study of asymptomatic Koreans

Authors
 Yun Jeong Lee  ;  Su Jung Baik  ;  Hyojin Park  ;  Jae Jun Park  ;  Donghee Han  ;  Hye Sun Lee  ;  Byoung Kwon Lee 
Citation
 MEDICINE, Vol.98(42) : e17629, 2019 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2019
MeSH
Adenoma/complications* ; Adenoma/diagnosis ; Asymptomatic Diseases ; Calcium/metabolism* ; Colonoscopy ; Colorectal Neoplasms/complications* ; Colorectal Neoplasms/diagnosis ; Coronary Angiography/methods ; Coronary Artery Disease/diagnosis ; Coronary Artery Disease/epidemiology ; Coronary Artery Disease/etiology* ; Coronary Vessels/diagnostic imaging* ; Coronary Vessels/metabolism ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Multidetector Computed Tomography ; ROC Curve ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Assessment/methods* ; Risk Factors ; Vascular Calcification/diagnosis ; Vascular Calcification/epidemiology ; Vascular Calcification/etiology*
Abstract
The potential relationship between coronary artery calcium (CAC) and colorectal adenoma has been widely indicated. This study aimed to investigate the relationship between the risk of colorectal adenoma and CAC progression in asymptomatic Korean adults who underwent serial assessments by colonoscopy and CAC scan.A total of 754 asymptomatic participants, who had undergone serial CAC scans and colonoscopies for screening, were enrolled. Changes in CAC were assessed according to the absolute change between baseline and follow-up results. CAC progression was defined using Multi-Ethnic Study of Atherosclerosis method. Risk for adenoma at follow-up colonoscopy was determined using hazard ratio (HR) by Cox regression. The area under the receiver operating characteristic (ROC) curve was measured.The mean follow-up duration was 3.4 ± 2.5 years. CAC progression was found in 215 participants (28.5%). Participants with adenoma at index colonoscopy showed a higher rate of CAC progression than those without (38.8% vs 23.6%, P < .01). In participants with adenoma at index colonoscopy, CAC progression significantly increased the cumulative risk for adenoma at follow-up colonoscopy (HR = 1.48, 95% confidence interval [CI] 1.06-2.06, log-rank P = .021). In multivariate analysis, male sex (HR = 2.57, 95% CI 1.22-5.42, P = .013), ≥3 adenomas at index colonoscopy (HR = 2.60, 95% CI 1.16-5.85, P = .021), and CAC progression (HR = 2.74, 95% CI 1.48-5.08, P = .001) increased the risk of adenoma at follow-up colonoscopy. In participants without adenoma at index colonoscopy, neither baseline CAC presence nor CAC progression increased the risk of adenoma at follow-up colonoscopy. The interaction between CAC progression and adenoma at index colonoscopy was significant in multivariable model (P = .005). In the ROC analysis, AUC of CAC progression for adenoma at follow-up colonoscopy was 0.625 (95% CI 0.567-0.684, P < .001) in participants with adenoma at index colonoscopy.Participants with CAC progression, who are at high risk of coronary atherosclerosis, may need to be considered for follow-up evaluation of colorectal adenoma, especially those with adenoma at index colonoscopy.
Files in This Item:
T201904035.pdf Download
DOI
10.1097/MD.0000000000017629
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
7. Others (기타) > Others (기타) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Park, Jae Jun(박재준)
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Baik, Su Jung(백수정) ORCID logo https://orcid.org/0000-0002-3790-7701
Lee, Byoung Kwon(이병권) ORCID logo https://orcid.org/0000-0001-9259-2776
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Han, Donghee(한동희)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173152
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse