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Atrial Fibrillation: A New Indicator for Advanced Colorectal Neoplasia in Screening Colonoscopy
- Source :
- Journal of Clinical Medicine, Volume 8, Issue 7, Journal of Clinical Medicine, Vol 8, Iss 7, p 1083 (2019)
- Publication Year :
- 2019
- Publisher :
- MDPI AG, 2019.
-
Abstract
- Background: Colorectal cancer (CRC) is a common and potentially preventable malignancy. Evidence has emerged that coronary artery disease patients are at increased risk for developing CRC by shared risk factors. Here we investigated an association between CRC and atrial fibrillation (AF), a surrogate marker of cardiovascular risk, in the setting of routine screening colonoscopy. Methods: We investigated 1949 asymptomatic participants (median age 61 [54&ndash<br />67] years, 49% females) undergoing screening colonoscopy within the SAKKOPI registry (Salzburg Colon Cancer Prevention Initiative). Forty-six participants with AF (2.4%) were identified, and colonoscopy findings were compared to non-AF participants. Propensity Score Matching (PSM) was used to create 1:1 and 3:1 age- and gender-matched couples. Results: Abnormal findings on screening colonoscopy (any form of adenoma or carcinoma) were more common in AF participants with an odds ratios (OR) of 2.4 [1.3&ndash<br />4.3] in the unmatched analysis, and 2.6 [1.1&ndash<br />6.3] and 2.0 [1.1&ndash<br />4.0] in the 1:1 and 3:1 matched groups, respectively. Correspondingly, the odds of finding advanced adenomas or carcinomas was elevated about three-fold across the different matched and unmatched analyses (OR 3.3 [1.1&ndash<br />10.8] for 3:1 matched participants). At the same time, the prevalence and number of colonic lesions were significantly higher in AF participants (63.0% vs. 33.4% for 3:1 matched participants, p &lt<br />0.001). Non-CRC related findings on colonoscopy, like diverticulosis, were non-different between groups. Conclusion: Participants with AF had a higher burden of advanced premalignant adenomas and CRC in routine colonoscopy screening. Our data suggest that practitioners should monitor the CRC screening status, especially in AF patients.
- Subjects :
- medicine.medical_specialty
Adenoma
Colorectal cancer
lcsh:Medicine
Colonoscopy
colorectal cancer
610 Medicine & health
030204 cardiovascular system & hematology
Asymptomatic
Article
03 medical and health sciences
0302 clinical medicine
prevention
Internal medicine
medicine
atrial fibrillation
030212 general & internal medicine
medicine.diagnostic_test
business.industry
Surrogate endpoint
screening
lcsh:R
General Medicine
Odds ratio
medicine.disease
digestive system diseases
Diverticulosis
Propensity score matching
10209 Clinic for Cardiology
medicine.symptom
business
Subjects
Details
- ISSN :
- 20770383
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....f8b441408966754d94c294e9ebaf1b77
- Full Text :
- https://doi.org/10.3390/jcm8071083