Colorectal adenoma is associated with coronary artery calcification in a Korean population

- Colorectal adenoma is related to coronary artery calcification independent of traditional risk factors.
- The prevalence of colorectal adenoma and advanced adenoma increased progressively with increasing CAC score.
- It is important to prevent the modifiable risk factors common to both colorectal neoplasm and coronary artery disease.

ObjectiveColorectal adenoma and coronary atherosclerosis have similar risk factors. The aim of this study was to investigate the association between colorectal adenoma and coronary artery calcification (CAC), which is used as a surrogate marker for coronary atherosclerosis.MethodsThis is a cross-sectional study of 398 Koreans (290 males, mean age of 56.8 ± 8.1 years) who underwent CAC scoring by multi-slice computed tomography and colonoscopy on the same day as the screening examination. The CAC scores were divided into the following three categories according to severity: absent (CAC score = 0), mild (0 < CAC score ≤ 100), and moderate-to-severe CAC (CAC score > 100).ResultsColorectal adenoma was detected in 149 (37.4%) subjects and was significantly associated with a CAC score of >0 (OR = 1.66, 95% CI = 1.05-2.64, P = 0.032), including both mild (OR = 1.80, 95% CI = 1.06-3.03, P = 0.029) and moderate-to-severe CAC (OR = 1.95, 95% CI = 1.05-3.63, P = 0.035), in multivariate analysis after adjusting for age, gender and other risk factors. The proportion of subjects with colorectal adenoma and advanced adenoma progressively increased with increasing CAC score (colorectal adenoma 28.9%-54.1%, P for trend < 0.001; advanced adenoma 7.0%-16.4%, P for trend = 0.026).ConclusionColorectal adenoma is related to coronary artery calcification independent of traditional risk factors for asymptomatic Koreans. The prevalence of advanced adenoma is more common in individuals with severe coronary atherosclerosis.

Prevalences of colorectal adenoma and advanced adenoma according to the coronary artery calcification score (CACS). The proportion of subjects with colorectal adenoma and advanced adenoma progressively increased with increasing CAC score (P for trend < 0.001 and P for trend = 0.026, respectively).89