title: 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.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Charité-Campus Benjamin Franklin (CBF), Department of Cardiology, Berlin, Germany.
authors.forename: Markus S
authors.initials: MS
authors.lastname: Anker
authors.affiliation: Innovative Clinical Trials, University Medicine Gottingen (UMG), Department of Cardiology and Pneumology, Gottingen, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Ebner
authors.affiliation: Charité-Campus Virchow-Klinikum (CVK), Department of Hematology and Oncology, Berlin, Germany.
authors.forename: Bert
authors.initials: B
authors.lastname: Hildebrandt
authors.affiliation: Innovative Clinical Trials, University Medicine Gottingen (UMG), Department of Cardiology and Pneumology, Gottingen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Springer
authors.affiliation: Charité-Campus Virchow-Klinikum (CVK), Department of Hematology and Oncology, Berlin, Germany.
authors.forename: Marianne
authors.initials: M
authors.lastname: Sinn
authors.affiliation: Charité-Campus Virchow-Klinikum (CVK), Department of Hematology and Oncology, Berlin, Germany.
authors.forename: Hanno
authors.initials: H
authors.lastname: Riess
authors.affiliation: Innovative Clinical Trials, University Medicine Gottingen (UMG), Department of Cardiology and Pneumology, Gottingen, Germany.
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.affiliation: Charité-Campus Benjamin Franklin (CBF), Department of Cardiology, Berlin, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Landmesser
authors.affiliation: Charité-Campus Virchow-Klinikum (CVK), Department of Cardiology, Berlin, Germany.
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Haverkamp
authors.affiliation: Innovative Clinical Trials, University Medicine Gottingen (UMG), Department of Cardiology and Pneumology, Gottingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: von Haehling
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000503:physiopathology*; D016022:Case-Control Studies; D002423:Cause of Death; D015179:Colorectal Neoplasms / Q000401:mortality / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000503:physiopathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate
keywords: Cancer; Heart rate; Survival