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首页> 外文期刊>The American Journal of Cardiology >Comparison of coronary calcium in firefighters with abnormal stress test findings and in asymptomatic nonfirefighters with abnormal stress test findings
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Comparison of coronary calcium in firefighters with abnormal stress test findings and in asymptomatic nonfirefighters with abnormal stress test findings

机译：压力测试结果异常的消防员与无压力测试结果的无症状非消防员的冠状动脉钙比较

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Firefighters are known to have an elevated rate of sudden cardiac death compared to the general population. It is unclear whether this finding is related to underlying cardiovascular risk factors or whether firefighting inherently carries additional risk. Our objective was to determine whether Los Angeles county firefighters have higher coronary artery calcium (CAC) scores and increased atherosclerosis as determined using 64-slice cardiac, multidetector computed tomography. A total of 647 asymptomatic firefighters evaluated as a part of a wellness protocol were referred for cardiac multidetector computed tomography to evaluate abnormal exercise treadmill test findings. They were matched by age and cardiovascular risk factors, with 2,533 asymptomatic subjects undergoing cardiac computed tomography because of abnormal electrocardiographic or exercise treadmill test findings. CAC and the prevalence of obstructive coronary artery disease by vessel were derived. Finally, the predictors of CAC were analyzed using regression analysis. Of the firefighters, 49% had detectable CAC compared to 43% of controls (p = 0.015). Although the lesions were most prevalent in the left anterior descending artery in both groups, more firefighters had any left anterior descending artery stenosis compared to the controls (p <0.0001). The firefighters also had more left main coronary artery lesions than did the controls (p <0.0001). The firefighters had significantly greater CAC scores than did with the controls (p <0.001). Furthermore, the firefighters had significantly greater mean CAC scores (66 ± 8 in firefighters vs 33 ± 4 for controls, p <0.001). Firefighter status was independently associated with a 41-point increase in the CAC score (p <0.001). In conclusion, asymptomatic firefighters had more atherosclerosis and CAC than the matched controls.
机译：与普通人群相比，消防员的心脏猝死率更高。目前尚不清楚这一发现是否与潜在的心血管危险因素有关，还是消防固有地带来额外的危险。我们的目标是确定洛杉矶县消防员是否具有较高的冠状动脉钙（CAC）评分和增加的动脉粥样硬化，如使用64层心脏多探测器计算机断层扫描所确定的。共有647名作为健康规程一部分进行评估的无症状消防员被推荐进行心脏多探测器计算机断层扫描，以评估异常运动跑步机的测试结果。他们根据年龄和心血管危险因素进行了匹配，有2533名无症状受试者因心电图或运动跑步机测试结果异常而接受了心脏计算机断层扫描。得出CAC和阻塞性冠状动脉疾病的患病率。最后，使用回归分析分析了CAC的预测因子。在消防员中，有49％的人可检测到CAC，而对照组中只有43％（p = 0.015）。尽管两组的病变在左前降支中最普遍，但与对照组相比，有更多的消防员患有左前降支狭窄（p <0.0001）。消防员的左主冠状动脉病变也比对照组多（p <0.0001）。消防员的CAC得分明显高于对照组（p <0.001）。此外，消防员的平均CAC分数明显更高（消防员为66±8，对照组为33±4，p <0.001）。消防员的身分与CAC得分增加41分有关（p <0.001）。总之，无症状消防员的动脉粥样硬化和CAC高于相匹配的对照组。

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