Key result
Advanced colorectal neoplasia linked to ~65% higher odds of subclinical obstructive CAD on CCTA.
Why the study?
Advanced colorectal neoplasia and CAD share common pathogenic mechanisms, but their association in asymptomatic individuals undergoing screening required investigation.
Does the presence of advanced colorectal neoplasia associate with subclinical coronary atherosclerosis in asymptomatic individuals?
Cohort (n=6,044)
No
Does the presence of advanced colorectal neoplasia associate with subclinical coronary atherosclerosis in asymptomatic individuals?
Effect estimate: OR 1.65 (95% CI 1.09-2.50)
Absolute Event Rate: 15.4% vs 5.8%
p-value: p=0.019
In asymptomatic individuals, the presence of advanced colorectal neoplasia is independently associated with obstructive coronary artery disease on CCTA, suggesting a shared pathogenic mechanism and a potential need for cardiovascular risk assessment in this population.
May warrant CV risk assessment in advanced colorectal neoplasia; extends evidence for shared pathogenic mechanisms with obstructive CAD.
Background: Advanced colorectal neoplasia (CRN) and coronary artery disease (CAD) are major health problems with common underlying pathogenic mechanisms.This study sought to investigate the association between the presence of advanced CRN and subclinical coronary atherosclerosis through a large cohort of asymptomatic Korean individuals who voluntarily underwent colonoscopy and coronary computed tomography angiography (CCTA) as routine health screening tests.Methods: A total of 6,044 Korean individuals aged 20 years who underwent a general health examination at the Health Promotion Center of Ulsan University Hospital between January 2009 and March 2020 were retrospectively analyzed.Advanced CRN was defined as the presence of invasive cancer or adenoma with a villous component, high-grade dysplasia, and/or a size of 1 cm.Subclinical coronary atherosclerosis was evaluated by CCTA.Results: Participants with any CRN (n = 1,916, 31.7%) or advanced CRN (n = 240, 4.0%) had a higher coronary artery calcium score and a higher prevalence of any coronary, calcified, mixed, and non-calcified plaques, and obstructive CAD ( 50% diameter stenosis) on CCTA compared with participants with non-CRN (n = 4,128, 68.3%) (all P < 0.05).In the multivariable analysis to evaluate the association between CRN and CCTA findings, the advanced CRN group showed a statistically significant association with obstructive CAD (odds ratio, 1.65; 95% confidence interval, 1.09-2.50;P = 0.019).Conclusion: Asymptomatic subjects with CRN showed a higher prevalence of subclinical coronary atherosclerosis compared to those with non-CRN.Advanced CRN was independently associated with obstructive CAD on CCTA.
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Park et al. (2026) conducted a cohort in Asymptomatic individuals (n=6,044). Advanced colorectal neoplasia vs. No colorectal neoplasia was evaluated on Obstructive coronary artery disease (≥ 50% diameter stenosis) on CCTA (OR 1.65, 95% CI 1.09-2.50, p=0.019). Advanced colorectal neoplasia was independently associated with obstructive coronary artery disease on CCTA in asymptomatic individuals (OR 1.65).
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