Resting heart rate is an independent predictor of advanced colorectal adenoma recurrence

BACKGROUND AND AIM High heart rate is an independent predictor of total cancer incidence and all-cause mortality in patients with cancer. We aimed to evaluate the impact of resting heart rate on the recurrence of colorectal polyp, using long-term surveillance follow-up data of colorectal cancer survivors. METHODS Three hundred patients were selected from the colorectal cancer survivor cohort of Severance Hospital, Seoul, Korea. Resting heart rate, physical activity, and body composition analysis at the time of 5-year survival, and clinical data including colonoscopy surveillance results were collected for mean follow-up duration of 8 years. RESULTS Patients with a high resting heart rate showed a significantly higher recurrence rate of advanced adenoma than those with a low resting heart rate (quartile 1, 45-66 beats per minute (b.p.m.); quartile 2, 67-73 b.p.m.; quartile 3, 74-80 b.p.m.; quartile 4, 81-120 b.p.m.; 3.8% vs. 7.9% vs. 10.0% vs. 14.7%, p for trend = 0.018). After adjustment for various risk factors, patients in the highest quartile of resting heart rate (≥ 81 b.p.m.) had a significantly higher risk of advanced adenoma recurrence (hazard ratio [HR]: 6.183, 95% confidence interval [CI]: 1.181-32.373, p = 0.031), compared to those in the lowest quartile (≤ 66 b.p.m.). In subgroup analysis, the association of resting heart rate with advanced adenoma recurrence appeared to be stronger among patients who had more than normal body fat mass or sedentary life style. CONCLUSIONS Elevated resting heart rate was independently associated with a higher rate of advanced adenoma recurrence in colorectal cancer survivors.