Elevated Resting Heart Rate is an Independent Risk Factor for Mortality in Patients with Colorectal Cancer: A Retrospective Cohort Study

Abstract Background: Although lifestyle factors are associated with resting heart rate (RHR), its association with mortality in colorectal cancer (CRC) patients has not been fully understood. Therefore, we sought to determine whether RHR is associated with all-cause and CRC-specific mortality in stage 1-3 CRC patients. Methods: We included a total of 3,631 patients from the Severance Hospital Colorectal Cancer Registry (Seoul, South Korea) who underwent surgery for stage 1-3 CRC. RHR data were collected on the day of surgery. We utilized multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between RHR and all-cause and CRC-specific mortality. Results: During a median follow-up of 3.0 years, there were 292 all-cause and 177 CRC-specific deaths. Patients in the highest quintile of RHR (≥88 bpm) (≤66 bpm) vs. patients in the lowest quintile of RHR showed a 3.33-fold increased risk of all-cause mortality (95% CI:1.85–5.99) and a 2.98-fold increased risk of CRC-specific mortality (95% CI:1.74–5.05). For every 10-bpm increase in RHR, there was a 1.44-fold increase in all-cause mortality (95% CI:1.32–1.58) and a 1.50-fold increase in CRC-specific mortality (95% CI:1.33–1.69). Conclusions: Elevated RHR on the day of surgery for CRC is associated with higher risk of all-cause/CRC-specific mortality. Impact: Our data suggest that RHR may serve as a clinically relevant predictor of mortality in patients who undergo surgery for CRC.