title: Coronary calcium scanning independently detects coronary artery disease in asymptomatic firefighters: a prospective study.
abstract: BACKGROUND
  Sudden cardiac death is the leading cause of death among firefighters in the United States. Fire departments commonly maintain physical examination protocols, often with exercise stress testing, to detect risk of coronary heart disease.
  
  
  OBJECTIVE
  We sought to determine whether coronary calcium detected by electron beam computed tomography (EBCT) adds incremental risk stratification beyond the traditional risk factors in asymptomatic community-based firefighters.
  
  
  METHODS
  Three hundred ninety nine asymptomatic firefighters underwent a coronary calcium scan on a GE/Imatron C-150 Ultrafast EBCT scanner, using standardized imaging protocols. Framingham risk factor data were obtained on each patient by using a questionnaire. Agatston scores were derived and compared with national database of Agatston scores for asymptomatic populations on the basis of age and sex, allowing determination of a calcium percentile for each score.
  
  
  RESULTS
  Coronary calcium was found only in men >34 years of age. Of the 53% who had positive scans (Agatston score > 0), 87% had higher than average Agatston scores compared with a national database (P < 0.01). Agatston score above the 75th percentile was found in 57% of firefighters. No correlation was observed between traditional risk factors and those with and without coronary calcium.
  
  
  CONCLUSIONS
  Firefighters have a high burden of calcified coronary atherosclerosis, greater than anticipated on the basis of age and coronary risk factors.
authors: Orange County Heart Institute and Research Center, 1140 West La Veta, Ste 640, Orange, CA 92668, USA. lsantora@cox.net
authors: Lawrence J
authors: LJ
authors: Santora
authors: Priya
authors: P
authors: Pillutla
authors: Teresa
authors: T
authors: Norris
authors: Rina
authors: R
authors: Santora
authors: Richard
authors: R
authors: Brandt
authors: Mark
authors: M
authors: Jenkins
authors: Mary
authors: M
authors: Robinson
authors: Nicole
authors: N
authors: Santora
authors: Matthew J
authors: MJ
authors: Budoff
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D015897:Comorbidity; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D061388:Firefighters / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D055815:Young Adult