What is the prevalence of angiographically demonstrated coronary artery disease in asymptomatic men with abnormal exercise treadmill tests?
In asymptomatic aircrewmen with abnormal exercise tests, over half have angiographically proven coronary artery disease, supporting the use of elective coronary angiography in this high-stakes population.
This report presents the results of coronary angiography in 76 asymptomatic aircrewmen with exercise testing responses suggestive of coronary artery disease. There were two subgroups: 18 men with normal resting electrocardiograms; and 58 men with a history of repolarization changes on their resting electrocardiogram after at least one normal ECG. Of the 76 men, 53% had angiographically demonstrated coronary artery disease, and many of them had high risk lesions. Forty-seven percent had no angiographic evidence of lesions and were recommended for return to flying status. Those individuals with normal angiograms will be closely followed at the USAF School of Aerospace Medicine in an effort to determine their natural history and prognosis. The findings in this study, the lack of significant complications resulting from coronary angiography, the concern for public safety, and the economics of maintaining a flying force all support the continued use of elective coronary angiography in selected asymptomatic aircrewmen.
Froelicher et al. (Sat,) studied this question.
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