Abstract 13351: Firefighter Coronary Atherosclerotic Burden Compared to Non-Firefighters

Abstract

Introduction: Cardiovascular (CV) disease is the leading cause of death for on-duty firefighters. According to the National Fire Protection Association (NFPA), 44% of all fatalities were due to sudden cardiac deaths, and 90% of which were due to coronary artery disease. Furthermore, firefighters are prone to occupational behaviors, conditions, and environmental exposures that may increase their adverse outcomes. In this study, we will attempt to explore the atherosclerotic differences between firefighters and non-firefighter individuals. Methods: 302 firefighters from the Los Angeles fire department who underwent coronary computed tomography angiogram from 2008 to 2021 were matched 1:1 for age, gender, race, diabetes mellitus (DM), hyperlipidemia (HLD), hypertension (HTN), and past smoking to a control cohort for comparison of semi-quantitative coronary plaque burden. Each coronary segment was assessed by a semi-quantify plaque severity (0 for no plaque, 1 for minimal or mild, 2 for moderate, 3 for severe) and luminal stenosis (0: none, 1: <30%, 2: 30-49%, 3: 50-69%, 4: 70-99% and 5:100%). The total plaque severity score (TPS) was calculated by the sum of the individual segment plaque severity score. The total segment stenosis score (TSS) was calculated by adding all the individual segment stenosis score (SSS). Segment involvement score (SIS) was calculated by summing the total number of coronary segments with plaque. Results: Mean (SD) age was 51.3 (6.6); 2% were diabetic; 34% had hyperlipidemia; 19% were hypertensive; 10% were prior smokers in each cohort. The Fire Fighter cohort had significantly higher coronary calcium scores (mean 42.5 vs 12); p<0.0001, TPS at 3 (IQR (1,6) vs 2 (IQR (0,5)); p<0.0001, TSS 3 (IQR (1,5) vs 2 (IQR (0,5)); p<0.0001 , and SIS 2 (IQR (1,4) vs 2 (IQR (0,4)); p<0.0001. Conclusions: After matching for age, gender, race, DM, HTN, HLD, and past smoking. Firefighters had more plaque burden, more stenosis, and more diffuse disease when compared to nonfirefighters, illustrating the occupational effects on the atherosclerotic process