Elevated Resting Heart Rate Is an Independent Risk Factor for Mortality in Patients with Colorectal Cancer: A Retrospective Cohort Study

Abstract

Background: Although lifestyle factors are associated with resting heart rate (RHR), its association with mortality in patients with colorectal cancer has not been fully understood. Therefore, we sought to determine whether RHR is associated with all-cause and colorectal cancer-specific mortality in patients with stage I to III colorectal cancer.Methods: We included a total of 3,631 patients from the Severance Hospital Colorectal Cancer Registry (Seoul, South Korea) who underwent surgery for stage I to III colorectal cancer. RHR data were collected on the day of surgery. We utilized multivariable Cox proportional hazards models to estimate HRs and 95% confidence intervals (CI) for the association between RHR and all-cause and colorectal cancer-specific mortality.Results: During a median follow-up of 3.0 years, there were 292 all-cause and 177 colorectal cancer-specific deaths. Patients in the highest quintile of RHR [>= 88 beats per minute (bpm)] versus patients in the lowest quintile of RHR (<= 66 bpm) showed a 3.33-fold increased risk of all-cause mortality (95% CI, 1.85-5.99) and a 2.98-fold increased risk of colorectal cancer-specific mortality (95% CI, 1.72-5.16). For every 10-bpm increase in RHR, there was a 1.44-fold increase in all-cause mortality (95% CI, 1.32-1.58) and a 1.50-fold increase in colorectal cancer-specific mortality (95% CI, 1.33-1.69).Conclusions: Elevated RHR on the day of surgery for colorectal cancer is associated with a higher risk of all-cause/colorectal cancer-specific mortality.Impact: Our data suggest that RHR may serve as a clinically relevant predictor of mortality in patients who undergo surgery for colorectal cancer.