ArticleJournal of the American Heart Association2018
Pathoanatomic Findings Associated With Duty-Related Cardiac Death in US Firefighters: A Case-Control Study.
Article in Journal of the American Heart Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 57 citations in OpenAlex.
- Anthocyanin Intake and Physical Activity: Associations with the Lipid Profile of a US Working Population.Molecules (Basel, Switzerland) · 2020Trial
- Prevention of atherosclerotic coronary artery disease in tactical athletes.American journal of preventive cardiology · 2026Review
- Glucose as a Biomarker for Stress in Firefighters.Journal of occupational and environmental medicine · 2026Article
- A cross-sectional assessment of the individual- and fire department-level factors affecting volunteer firefighter cardiorespiratory fitness.Fire (Basel, Switzerland) · 2025Article
- Hydration Considerations to Improve the Physical Performance and Health of Firefighters.Journal of functional morphology and kinesiology · 2024Review
- The dietary inflammatory index and cardiometabolic parameters in US firefighters.Frontiers in nutrition · 2024Article
- Association between Physical Fitness and Cardiovascular Health in Firefighters.International journal of environmental research and public health · 2023Article
- Article
- Physical fitness, cardiovascular and musculoskeletal health, and occupational performance in firefighters.Frontiers in public health · 2023Article
- The Wildland Firefighter Exposure and Health Effect (WFFEHE) Study: Rationale, Design, and Methods of a Repeated-Measures Study.Annals of work exposures and health · 2022Article
- Exploring the criteria and factors affecting firefighters' resilience: A qualitative study.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2022Article
- Left ventricular hypertrophy and sudden cardiac death.Heart failure reviews · 2022Review
- Low testosterone and cardiometabolic risks in a real-world study of US male firefighters.Scientific reports · 2021Article
- Cardiovascular Disease Risk Factors by BMI and Age in United States Firefighters.Obesity (Silver Spring, Md.) · 2021Article
- Differences in 5-year weight change between younger and older US firefighters.BMC public health · 2021Article
- Hypertension in the United States Fire Service.International journal of environmental research and public health · 2021Article
- Are there sex differences in physiological parameters and reaction time responses to overload in firefighters?PloS one · 2021Article
- A Cross-Sectional Examination of 10-Year Atherosclerotic Cardiovascular Disease Risk Among US Firefighters by Age and Weight Status.Journal of occupational and environmental medicine · 2020Article
- Association of the Modified Mediterranean Diet Score (mMDS) with Anthropometric and Biochemical Indices in US Career Firefighters.Nutrients · 2020Article
- Borderline-low testosterone levels are associated with lower left ventricular wall thickness in firefighters: An exploratory analysis.Andrology · 2020Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background 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.
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