SCCT: CCTA shows plaque burden progression in firefighters

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.