Coronary Calcium Scanning and Cardiovascular Risk Assessment Among Firefighters
| Autor: | Elizabeth V Ratchford, Kathryn A. Carson, M. Dominique Ashen |
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| Rok vydání: | 2022 |
| Předmět: |
Male
medicine.medical_specialty Epidemiology Population Risk Assessment Sudden cardiac death Risk Factors Internal medicine Diabetes mellitus medicine Humans education Aged Cause of death education.field_of_study Framingham Risk Score business.industry Public Health Environmental and Occupational Health medicine.disease Blood pressure Cardiovascular Diseases Heart Disease Risk Factors Firefighters Calcium Metabolic syndrome Risk assessment business |
| Zdroj: | American Journal of Preventive Medicine. 62:18-25 |
| ISSN: | 0749-3797 |
| DOI: | 10.1016/j.amepre.2021.06.005 |
| Popis: | Sudden cardiac death is the main cause of death among firefighters. The goal of this study is to identify firefighters at risk for cardiovascular disease using coronary artery calcium screening.Asymptomatic firefighters aged ≥40 years without known cardiovascular disease or diabetes (N=487) were recruited from fire departments in 3 Maryland counties from 2016 to 2018, with data analysis from 2018 to 2019. The cardiovascular disease prevention program included an evaluation of blood pressure, cholesterol, BMI, fasting glucose, medications, and a coronary calcium scan. A subset (n=100) was evaluated in more detail, including family history, metabolic syndrome, diet, exercise, smoking, and atherosclerotic cardiovascular disease risk score.Results indicated that 191 (39%) firefighters had a coronary artery calcium score0, of which 91% were above the average for age, sex, and ethnicity. On univariable logistic regression, older age, male sex, hypertension, BMI, and glucose were significantly (p0.05) associated with a higher likelihood of having any coronary artery calcium. Multiple logistic regression found that older age; male sex; taking lipid-lowering or antihypertensive medications; and higher low-density lipoprotein cholesterol, BMI, and fasting blood glucose were significantly associated with a higher likelihood of having coronary artery calcium. Of those with coronary artery calcium, 141 (74%) were not on lipid-lowering medication. In addition, 47 (94%) of those on lipid-lowering medication had a low-density lipoprotein cholesterol70 mg/dL. In the detailed subset, 30 (30%) had coronary artery calcium. Among these, 28 (93%) had an atherosclerotic cardiovascular disease risk score7.5%. Thus, if atherosclerotic cardiovascular disease scores alone were used to assess risk in this subset, an opportunity would have been missed to identify and treat firefighters who may have benefited from more aggressive treatment.A coronary artery calcium scan may identify the firefighters at increased risk for cardiovascular disease. A comprehensive cardiovascular disease prevention program implemented early in a firefighter's career may help reduce cardiovascular disease risk and thus death and disability in this high-risk population. |
| Databáze: | OpenAIRE |
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