P2233 - Rising Cardiovascular Disease Risk and Acute Cardiovascular Events Among Hospitalized Colon Cancer Survivors: Evidence From Two Nationwide Cohorts a Decade Apart

Shreyans Doshi, MD¹, Rupak Desai, MBBS², Lorannys Y. Sanchez Tamarez, MD³, Mirian Galan, MD⁴, Maria Rueda, ⁵, Christiana A. Igbenabor, MBBS⁶, Confesora Valdez-Aquino, MD⁷, Violeta Spasova, MD⁸, Zaymis D. Mejia, MD⁷, Sandeep Singh, MBBS^9
1August Georg University, Augusta, GA; ²Independent Researcher, Atlanta, GA; ³Universidad Autonoma de Santo Domingo, San Antonio, TX; ⁴Universidad Autónoma De Santo Domingo, Santo Domingo Oeste, Distrito Nacional, Dominican Republic; ⁵University of Zulia, Maracaibo, Zulia, Venezuela; ⁶Igbinedion University Okada, Edo State, Nigeria, Tracy, CA; ⁷Universidad Autonoma de Santo Domingo, Santo Domingo, Distrito Nacional, Dominican Republic; ⁸Medical University of Sofia Bulgaria, Darien, IL; ⁹Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam, Noord-Holland, Netherlands

Introduction: Improved diagnostics and therapeutics in the last decade have significantly improved survival in colon cancer patients. With improved survival it is essential to evaluate potential cardiovascular disease risk (CVD) secondary to cancer and associated chemotherapy/radiation toxicity. However, there is scarcity of large-scale data on the burden of CVD risk factors and acute cardiovascular events among colon cancer survivors in the past decade.

Methods: We curated National Inpatient Sample for hospitalizations among colon cancer survivors in the year 2007 and 2017. Demographically matched cohorts of colon cancer survivors in 2007 vs. 2017 were obtained to compare the CVD risk factors, and in-hospital outcomes including all-cause mortality, acute cardiovascular events (pulmonary embolism, arrhythmia, and stroke). We performed multivariable regression analysis, adjusting for demographics and comorbidities, to assess the risk of cardiovascular events across these two cohorts a decade apart.

Results: Of admissions among colon cancer survivors, the 2017 cohort often consisted of younger (76 years vs 77 years), male, African-American and Hispanic patients admitted non-electively compared to 2007 cohort (Table 1). Furthermore, the 2017 cohort had higher rates of smoking, alcohol abuse, drug abuse, coagulopathy, liver disease, weight loss and renal failure. Importantly, patients in 2017 cohort had higher rates of cardiovascular comorbidities including hypertension, hyperlipidemia, diabetes, obesity, peripheral vascular disease, congestive heart failure, and at-least one traditional CVD (p< 0.001) compared to 2007 cohort. On adjusted multivariable analysis, the 2017 cohort had significantly higher risk of pulmonary embolism (PE) (OR 1.47, 95%CI:1.37-1.58), arrhythmia (OR1.41 95%CI:1.38-1.43), atrial fibrillation/flutter (OR 1.61 95%CI:(1.58-1.64) cardiac arrest including ventricular tachyarrhythmia (OR 1.63 95%CI:1.46-1.82) and stroke (OR 1.28 95%CI:1.22-1.34) with comparable all-cause mortality and fewer routine discharges (48.4% vs 55.0%) (p< 0.001) compared to 2007 cohort.

Discussion: Colon cancer survivors hospitalized 10-years apart in the US showed an increasing CVD risk with an increased risk of acute cardiovascular events (stroke ~28%, PE 47%, arrhythmia 41% and cardiac arrest 63%). It is vital to regularly screen colon cancer survivors with concomitant CVD risk factors to curtail long-term cardiovascular complications associated with cancer and anticancer treatment.



Disclosures:


Shreyans Doshi, MD¹, Rupak Desai, MBBS², Lorannys Y. Sanchez Tamarez, MD³, Mirian Galan, MD⁴, Maria Rueda, ⁵, Christiana A. Igbenabor, MBBS⁶, Confesora Valdez-Aquino, MD⁷, Violeta Spasova, MD⁸, Zaymis D. Mejia, MD⁷, Sandeep Singh, MBBS⁹. P2233 - Rising Cardiovascular Disease Risk and Acute Cardiovascular Events Among Hospitalized Colon Cancer Survivors: Evidence From Two Nationwide Cohorts a Decade Apart, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.