Greater CAD Incidence, Heart Mass in Firefighter Cardiac Arrests
Predictors of cardiac death include heart weight >450 g, coronary artery stenosis, prior MI
FRIDAY, Sept. 7, 2018 (HealthDay News) -- Most cardiac fatalities among firefighters have evidence of coronary heart disease and increased heart mass, according to a study published online Sept. 5 in the Journal of the American Heart Association.
Denise L. Smith, Ph.D., from Skidmore College in Saratoga Springs, N.Y., and colleagues used autopsy data for duty-related firefighter fatalities occurring between 1999 and 2014. Cardiac findings of male firefighters aged 18 to 65 years who died on duty of cardiac-related causes were compared with those who died of non-cardiac trauma-related causes. Data were analyzed from 276 cardiac cases and 351 non-cardiac trauma controls.
The researchers found that the underlying pathoanatomic substrate was comorbid coronary heart disease and cardiomegaly/left ventricular hypertrophy in 82 percent of cardiac cases. The prevalence of cardiomegaly (heart weight >450 g), left ventricular hypertrophy (left ventricular wall thickness ≥1.2 cm), and severe coronary artery stenosis (≥75 percent) was increased for cardiac cases versus trauma controls (all P < 0.001). In multivariate analyses, strong independent predictors of cardiac death included heart weight >450 g (odds ratio, 6.1), coronary artery stenosis ≥75 percent (odds ratio, 9.3), and evidence of a prior myocardial infarction (odds ratio, 6.2).
"Targeted screening for coronary heart disease, increased heart mass, and evidence of prior myocardial infarction should be considered to reduce duty-related cardiac deaths among firefighters," the authors write.
One author serves as a paid expert witness, medical examiner, or both in workers' compensation and disability cases, including those involving firefighters. A second author reports serving as a consultant in cases involving medical evaluations and firefighter fatalities.