Clinical features of aviators with coronary artery disease diagnosed by multislice CT angiography

Coronary artery disease (CAD) is one of the most incapacitating causes at military or civilian aviation. Aircrew population is crowding in number in our country. We aimed to identify the clinical features that could predict CAD in aircrew.

We retrospectively analyzed medical recordings of 26 aircrew (age 43.57±5.2) whose CAD was diagnosed via multislice computerized tomography angiography (MSCT). Clinical features, coronary risk factors and ST segment and T wave changes on resting ECG and treadmill test (TT), and laboratory findings of aircrew were recorded.

ST depression <0.05 mV and minimally inversion (<0.03 mV) of T wave were found on 53.8% and 23.1% of resting ECG, respectively. 53.8% of patients had the family history of CAD. 73.1% of subjects were overweight. Family history was correlated with CAD and its type (p=0.023). 76.9% and 23.1% of the subjects had equivocal and positive result on TT, respectively. Presence of hypertension, hyperlipidemia, and smoking were lower and diabetes was absent. Additionally, subjects with two or more vessel disease were observed slightly older compared to those with one vessel disease (45.5±3.8 vs. 42.2±5.5, p=0.101).

Aircrew ≥40 years old, with family history, ST/T changes on resting ECG, and equivocal results on TT even in the absence of multiple coronary risk factors may need further cardiovascular tests. MSCT is an effective and noninvasive way of detection of CAD in aircrew when needed.