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Πεδίο DCΤιμήΓλώσσα
dc.contributor.authorSmith, Denise Louise-
dc.contributor.authorHaller, Jeannie M.-
dc.contributor.authorKorre, Maria-
dc.contributor.authorFehling, Patricia C.-
dc.contributor.authorSampani, Konstantina-
dc.contributor.authorGrossi Porto, Luiz Guilherme-
dc.contributor.authorChristophi, Costas A.-
dc.contributor.authorKales, Stefanos N.-
dc.date.accessioned2019-04-05T09:19:06Z-
dc.date.available2019-04-05T09:19:06Z-
dc.date.issued2018-09-01-
dc.identifier.citationJournal of the American Heart Association, 2018, vol. 7, no. 18en_US
dc.identifier.issn20479980-
dc.description.abstractBackground Sudden cardiac death accounts for the greatest proportion of duty-related deaths among US firefighters. Increased understanding of the pathoanatomic causes of sudden cardiac death and the risk associated with underlying cardiac pathologies is needed to develop evidence-based screening recommendations. Methods and Results Using autopsy data for duty-related firefighter fatalities occurring between 1999 and 2014, this retrospective case-control study compared cardiac findings of male firefighters aged 18 to 65 years who died on duty of cardiac-related causes with those who died of noncardiac trauma-related causes. Data from 276 cardiac cases and 351 noncardiac trauma controls were analyzed. Among cardiac cases, the most prevalent (82%) underlying pathoanatomic substrate was comorbid coronary heart disease and cardiomegaly/left ventricular hypertrophy. Cardiac cases had a higher prevalence of cardiomegaly (heart weight >450 g), left ventricular hypertrophy (left ventricular wall thickness ≥1.2 cm), and severe coronary artery stenosis (≥75%) than trauma controls (all P<0.001). In multivariate analyses, heart weight >450 g, coronary artery stenosis ≥75%, and evidence of a prior myocardial infarction were strong independent predictors of cardiac death, with odds ratios of 6.1 (95% confidence interval, 3.6-10.4), 9.3 (95% confidence interval, 5.3-16.1), and 6.2 (95% confidence interval, 3.4-11.3), respectively. Conclusions The majority of cardiac fatalities had evidence of both coronary heart disease and increased heart mass, and each condition was independently associated with a markedly elevated risk of cardiac death. 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.en_US
dc.formatpdfen_US
dc.language.isoenen_US
dc.relation.ispartofJournal of the American Heart Associationen_US
dc.rights© The Authorsen_US
dc.subjectAutopsyen_US
dc.subjectCardiomegalyen_US
dc.subjectCoronary heart diseaseen_US
dc.subjectFirefightingen_US
dc.subjectLeft ventricular hypertrophyen_US
dc.titlePathoanatomic Findings Associated With Duty-Related Cardiac Death in US Firefighters: A Case-Control Studyen_US
dc.typeArticleen_US
dc.collaborationCollege Saratoga Springs NYen_US
dc.collaborationCyprus University of Technologyen_US
dc.collaborationHarvard Universityen_US
dc.collaborationMedical School Cambridge MAen_US
dc.collaborationMedicine University of Brasiliaen_US
dc.subject.categoryClinical Medicineen_US
dc.journalsOpen Accessen_US
dc.countryUnited Statesen_US
dc.countryBrazilen_US
dc.countryCyprusen_US
dc.subject.fieldMedical and Health Sciencesen_US
dc.publicationPeer Revieweden_US
dc.identifier.doi10.1161/JAHA.118.009446en_US
dc.relation.issue18en_US
dc.relation.volume7en_US
cut.common.academicyear2018-2019en_US
item.fulltextWith Fulltext-
item.languageiso639-1en-
item.grantfulltextopen-
item.openairecristypehttp://purl.org/coar/resource_type/c_6501-
item.cerifentitytypePublications-
item.openairetypearticle-
crisitem.journal.journalissn2047-9980-
crisitem.journal.publisherWiley-
crisitem.author.deptDepartment of Rehabilitation Sciences-
crisitem.author.facultyFaculty of Health Sciences-
crisitem.author.orcid0000-0003-0503-1538-
crisitem.author.parentorgFaculty of Health Sciences-
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