Key result
Major adverse cardiovascular events within 30 days of colorectal cancer surgery were associated with a significantly increased risk of 5-year all-cause mortality (HR 1.25) compared to patients without such events.
Why the study?
Cardiovascular complications after noncardiac surgery are a leading cause of perioperative mortality, but limited knowledge exists regarding their impact on long-term mortality.
Does the occurrence of a major adverse cardiovascular event (MACE) within 30 days of colorectal cancer surgery increase long-term mortality and affect oncological outcomes?
Cohort (n=39,747)
Yes
Does the occurrence of a major adverse cardiovascular event (MACE) within 30 days of colorectal cancer surgery increase long-term mortality and affect oncological outcomes?
Hazard Ratio: 1.25 (95% CI 1.04–1.5)
Absolute Event Rate: 41.1% vs 24.3%
p-value: p=0.02
Experiencing a major adverse cardiovascular event within 30 days of colorectal cancer surgery is associated with a significantly increased risk of long-term all-cause mortality up to 5 years post-surgery.
Postoperative MACE after CRC surgery was associated with higher long-term mortality; leaves open whether preventive strategies improve survival.
Objective: To investigate the occurrence of major adverse cardiovascular events (MACE) following colorectal cancer (CRC) surgery and its association with long-term mortality and oncological outcomes. Background: Cardiovascular complications after noncardiac surgery are a leading cause of perioperative mortality. However, limited knowledge exists on how these complications impact on long-term mortality. Methods: This retrospective cohort study used data from 4 nationwide Danish health registries and included all patients undergoing elective surgery with curative intent for CRC between 2001 and 2019. Patients experiencing MACE, defined as acute myocardial infarction, stroke, new-onset heart failure, or nonfatal cardiac arrest, within 30 days of surgery were matched with those who did not using 1:1 propensity score matching (PSM). The outcomes were all-cause mortality within 1, 3, or 5 years of surgery, as well as 5-year cancer recurrence and disease-free survival. Results: Out of 39,747 patients, 900 (2.3%) had MACE. PSM resulted in 809 pairs of matched patients. Within 1 year of surgery, 110 (13.6%) patients with MACE and 2063 (5.4%) without MACE died (PSM-adjusted hazard ratio [HR] = 1.36; 95% confidence interval [CI] = 1.02-1.83). Within 3 years, 248 (30.6%) patients with MACE and 6268 (16.5%) without MACE died (PSM-adjusted HR = 1.32; 95% CI = 1.07-1.62). Within 5 years, 333 (41.1%) patients with MACE and 9232 (24.3%) without MACE died (PSM-adjusted HR = 1.25; 95% CI = 1.04-1.50). For recurrence and disease-free survival, no statistically significant differences were observed. Conclusions: MACE within 30 days of CRC surgery is associated with higher overall long-term mortality. Investigating causality and preventive measures is urgent in this group.
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Zahid et al. (2025) conducted a cohort in Colorectal cancer (n=39,747). Major adverse cardiovascular events (MACE) within 30 days of surgery vs. No MACE within 30 days of surgery was evaluated on 5-year all-cause mortality (HR 1.25, 95% CI 1.04-1.50, p=0.02). Major adverse cardiovascular events within 30 days of colorectal cancer surgery were associated with a significantly increased risk of 5-year all-cause mortality (HR 1.25) compared to patients without such events.
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