,
University Clinical Center Tuzla , Tuzla , Bosnia and Herzegovina
,
University Clinical Center Tuzla , Tuzla , Bosnia and Herzegovina
,
University Clinical Center Tuzla , Tuzla , Bosnia and Herzegovina
Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK, William Harvey Research Institute , London , United Kingdom
Aim To assess whether colorectal carcinoma (CRC) survivors 5 years post-fluoropyrimidine (5-fluorouracil and capecitabine) chemotherapy (ChemT) have increased presence of subclinical coronary artery disease (CAD), lower iron and altered blood cell composition.
Methods This prospective, 2 year, single-center study used invasive coronary angiography to detect the presence of CAD among ChemT (N=45) and control group patients (age, gender-matched, cancer-naïve (N=45). Full blood count and iron levels were compared between two groups.
Results Coronary angiography in 90 patients (mean age 65±7 years; 60% male) identified significantly higher presence of CAD in CRC ChemT patient group compared to control: 80% vs. 55 % (p=0.013). CRC ChemT patients had lower red blood cell count (4.45± 0.56 vs. 4.68± 0.50 x109/L; p=0.044), platelet count (214.18±50.99 vs. 251.00 ±156.40 x109/L; p=0.002) and white blood cell count (5.50 ±1.62 vs. 7.67±1.72 x109/L; p=0.000). Mean corpuscular hemoglobin concentration was higher in CRC ChemT patients (342.11 g/L ±15.74 vs. 336.42 g/L ±10.29: p=0.046), and iron deficiency was more prevalent (ChemT20.40 µmol/L ±3.891vs. control 23.37 µmol/L ±4.10: p=0.001).
Conclusion Our study shows that among CRC survivors who underwent 5-FU and capecitabine therapy there is a significantly higher prevalence of CAD accompanied by long-term impairment in blood erythropoiesis.
Keywords: coronary artery disease, coronary angiography, erythropoiesis
Data curation, I.I., L.A.N. and D.A.; Formal Analysis, I.I.; Investigation, I.I., A.K. and D.A.; Writing – original draft, I.I. and D.A.; Writing – review & editing, I.I., L.A.N. and D.A.; Resources, L.A.N.; Methodology, A.K. and D.A.; Software, A.K. and D.A.; Conceptualization, D.A.; Project administration, D.A.; Supervision, D.A.; Validation, D.A. All authors have read and agreed to the published version of the manuscript.
DA acknowledges Wellcome Trust Career Re-Entry Fellowship (221604/Z/20/Z) and Barts Charity Grant G-002145.
This work is licensed under a Attribution-NonCommercial-NoDerivatives 4.0 International 
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
