Cardiac CT angiography (CCTA) shows that baseline plaque coronary burden progresses in at-risk firefighters, according to research presented July 20 at the Society of Cardiovascular Computed Tomography (SCCT) annual meeting in Washington, DC.
A team led by Srikanth Krishnan, MD, from Harbor-UCLA Medical Center found that at-risk firefighters experience ongoing plaque progression, which can lead to cardiovascular disease.
“This study demonstrates elevated baseline plaque burden and its progression with increases in both non-calcified and calcified plaque volumes among Los Angeles County Firefighters,” the Krishnan team wrote.
Firefighters in their line of work are exposed to hazards that may spur the development and progression of cardiovascular disease, the leading cause of duty-related fatalities among them. Coronary heart disease makes up most cases, the researchers noted.
Krishnan and co-authors studied the progression of coronary plaque in firefighters over time using serial CCTA. The observational study included 62 Los Angeles County firefighters who underwent baseline and five-year follow-up CCTA between 2007 and 2021.
The firefighters had an average age of 53.6; of these, 98% were men and 66% were white. The researchers reported that among the study cohort, the prevalence of diabetes mellitus was 2%; of hyperlipidemia, 44%; of hypertension, 21%. Thirteen percent were past smokers.
Eleven of the firefighters had high-risk plaque. The team found that a “significant minority” of study participants had no detectable noncalcified or calcified plaque at baseline.
The median total plaque volume was 138.7 mm³, with noncalcified and calcified plaque volumes at 112.7 mm³ and 15.6 mm³, respectively. Finally, the annual median changes in total, noncalcified, and calcified plaque volumes were 12.5 mm³, 6.4 mm³, and 6.0 mm³, indicating ongoing plaque progression.
Krishnan and colleagues highlighted that their results “emphasize the need for comprehensive cardiovascular risk assessment and management strategies” in firefighters. They wrote that future studies will compare these findings to a matched control group. With this, they will evaluate the potential benefits of targeted preventive strategies for firefighters.
![Axial images from unenhanced calcium score cardiac CT (left) and curved planar reformation images from CT angiography (right) show that higher long-term exposure to air pollution is associated with greater coronary artery calcium and more obstructive coronary artery disease (CAD). Top row: Images in a 68-year-old male patient with higher 10-year mean ambient air pollution exposure (7.9 μg/m3 for particulate matter measuring ≤2.5 μm in diameter [PM2.5] and 17.4 parts per billion [ppb] for NO2) with extensive CAD (coronary artery calcium score [CACS] >1,000 and obstructive CAD [≥70% diameter stenosis]). Bottom row: Images in a 57-year-old female patient with lower 10-year mean ambient air pollution exposure (6.3 μg/m3 for PM2.5 and 4.6 ppb for NO2) with no CAD (CACS = 0 and no obstructive stenosis).](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/06/hanneman.r6SMLzkezo.png?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
