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Resting heart rate is an independent predictor of death in patients with colorectal, pancreatic, and non‐small cell lung cancer: results of a prospective cardiovascular long‐term study
Author(s) -
Anker Markus S.,
Ebner Nicole,
Hildebrandt Bert,
Springer Jochen,
Sinn Marianne,
Riess Hanno,
Anker Stefan D.,
Landmesser Ulf,
Haverkamp Wilhelm,
von Haehling Stephan
Publication year - 2016
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.670
Subject(s) - medicine , colorectal cancer , cardiology , heart failure , prospective cohort study , lung , oncology , cancer
Aims Patients with advanced cancer have been shown to suffer from abnormal cardiac function and impaired exercise capacity that may contribute to their impaired quality of life. As tachycardia is considered as a sign of potential early cardiac damage, we sought to determine whether resting heart rate and other ECG ‐derived variables have prognostic value. Methods and results From 2005 to 2010, we enrolled 145 patients with histologically confirmed cancer (36 colorectal, 72 pancreatic, and 37 non‐small cell lung cancer patients) and 59 healthy controls. During a mean follow‐up of 27 months, 82 patients (57%) died from any cause. The mean resting heart rate of healthy subjects was 70 ± 13 b.p.m., and that of cancer patients was 79 ± 14 b.p.m. ( P < 0.0001). As a sensitivity analysis, we excluded control subjects taking a beta‐blocker, but resting heart rate remained increased in cancer patients vs. controls ( P < 0.0001). Resting heart rate ≥75 b.p.m. [hazard ratio ( HR ) 1.84, 95% confidence interval ( CI ) 1.16–2.94; P = 0.01] significantly predicted survival in univariable analyses and remained an independent predictor of survival in a multivariate model ( HR 1.67, 95% CI 1.01–2.78; P = 0.04). Furthermore, the heart rate stayed significant in a second model that included age and sex as well. Conclusion The present study is the first to show that resting heart rate independently of haemoglobin and tumour stage predicts survival in patients with advanced colorectal, pancreatic, and non‐small cell lung cancer, and may therefore represent a therapeutic target.