Risk factors for cardiovascular mortality in patients with colorectal cancer: a population-based study

Patients with colorectal cancer are at increased risk of cardiovascular mortality compared to the general population. The purpose of this study is to identify risk factors of cardiovascular mortality in patients with colorectal cancer. A retrospective review of the Surveillance Epidemiology and End Results (SEER) database was performed between 2010 and 2014. Standardized Mortality Ratios (SMRs) for cardiovascular mortality were calculated by comparing the number of expected deaths in the United States according to the National Center for Health Statistics (ICD-10 codes I00-I99) to the number of observed deaths in the database. Logistic regression was used to identify independent risk factors. Overall, 164,719 patients were identified (mean age at diagnosis 67 ± 13.9 years, 52.7% males, 47.3% females), of which 4854 (2.9%) died from cardiovascular disease. The majority of cardiovascular deaths occurred during the first year after diagnosis (2658, 54.8%). SMRs for cardiovascular mortality were 11.7 (95% CI 11.3–12) among all patients, 12.1 (95% CI 11.7–12.6) for male patients and 11.1 (95% CI 10.6–11.6) for female patients, with SMRs being higher for younger patients. Older age, male sex, African–American race, elevated CEA and not undergoing curative surgery were independent risk factors of cardiovascular mortality in patients with colorectal cancer. Patients with colorectal cancer are associated with an increased risk of cardiovascular death, especially during the first year after diagnosis. Older age, male sex, African–American race, elevated CEA and not undergoing curative surgery are independent risk factors of cardiovascular death.