In asymptomatic firefighters, the burden of subclinical atherosclerosis as measured by both coronary artery calcification and carotid intimal medial thickening is associated with metabolic abnormalities and but not with standard traditional serological risk factors




Introduction


Asymptomatic firefighters have an increased risk of myocardial events during active duty and should be screened carefully for atherosclerosis and for risk factors for atherosclerosis that are potentially modifiable.




Objectives


We hypothesized that the burden of atherosclerosis measured by direct visualization of plaque in the coronary and peripheral vasculature would be superior to only measuring the presence of traditional risk factors.




Objectives


We hypothesized that the burden of atherosclerosis measured by direct visualization of plaque in the coronary and peripheral vasculature would be superior to only measuring the presence of traditional risk factors.




Methods


A total of 296 firefighters were recruited from Gwinnett County, Georgia, for this study. All firefighters, who were asymptomatic with no prior history of coronary artery disease, underwent CT coronary calcium scoring (CAC) on a 64-slice multidetector CT, measurement of carotid intimal thickening (CIMT) with high-resolution ultrasound, and measurement of metabolic and lipid characteristics. The prevalence of early atherosclerosis defined as CAC score >0 and CIMT score of >0.9 mm.




Results


The prevalence of early atherosclerosis by CAC and CIMT was 32% (96) and 28% (88), respectively. A total of 127 firefighters (43%) had evidence of early atherosclerosis by either positive CAC and/or positive CIMT. Fifty-two subjects (18%) had both abnormal CAC and CIMT and in 167 (56%) both were normal. Though the CAC+ and CIMT+ group had some strong association with metabolic factors, traditional serological markers (TC, HDL-C, LDL-C, or TG) were not significantly different between the groups. Age-adjusted logistic regression analysis showed that only SBP, BMI, and WHR were associated with early arthrosclerosis.

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Nov 16, 2017 | Posted by in CARDIOLOGY | Comments Off on In asymptomatic firefighters, the burden of subclinical atherosclerosis as measured by both coronary artery calcification and carotid intimal medial thickening is associated with metabolic abnormalities and but not with standard traditional serological risk factors

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