Korean J Aerosp Environ Med.  2013 Dec;23(3):78-81.

Coronary Artery Disease of Republic of Korea Civil Aviation Workers in 2010

• Kwon YH

Abstract

Background
Coronary artery disease (CAD) is a major disease that induces in-flight incapacitation, and it is a major cause of permanent medical disqualification for pilots. This study describes CAD of civil aviation workers by retrospective analysis of Aerospace Medical Association of Korea (AsMAK) review data on aviation physical examination. Methods: Subjects were 27 civil aviation workers (pilots and air traffic controllers) who have been diagnosed with CAD. The subjects were selected based on documents submitted in AsMAK from January to December in 2010. Periods of being diagnosed, risk factors, laboratory results, and others were reviewed with relevant AsMAK decision. The ones who are currently not on active duty because they were diagnosed with alleged CAD prior to 2010 and who were determined unfit on the aviation physical examination have been excluded from the analysis. The selection criteria are as follows: 1) the case wherein symptoms related to CAD not identified initially, but the stenosis of coronary artery is identified by coronary CT angiography or coronary angiography which are beyond electrocardiogram or stress electrocardiogram test or 2) the case wherein workers received urgent treatment such as percutaneous coronary intervention or coronary artery bypass graft surgery (CABG) due to myocardial infarction. Results and Conclusion: In 2010, 27 aviation workers were diagnosed as having CAD among 5850 aviation medical examinations. The average age of these workers was 55.1 years and the average body mass index (BMI) (kg/m2) was 24.7. The CAD risk factors at the time of diagnosis were obesity (40.7%), hyperlipidemia (29.6%), hypertension (7.4%), diabetes mellitus (7.4%), and taking of antihyperlipidemic medicines (7.4%). Smoking and family history were additional risk factors. Eight cases 29.6%) were newly diagnosed with CAD during 2010 and 19 cases were already diagnosed as it is. In regard to coronary angiography, involved coronary arteries were in the following order: left anterior descending 51.5%, right coronary 24.3%, left circumflex 21.2% and left main 3.0%. Among all CAD cases, single-vessel disease was comprising a large proportion of the cases (66.7%) and double-vessel disease (24.2%) and triple-vessel disease (9.1%) were followed. Graded range of vessel stenosis were mild (12.1%), moderate (24.3%) and obstructive (63.6%) respectively. The treatment modality for CAD cases was medication (44.4%) and percutaneous coronary angioplasty with stent placement (55.6%). CABG, a conventional way of CAD treatment was not attempted. AsMAK determined 23 cases (85.2%) as special issuance and 4 cases(14.8%) as denial. The period of follow-up after initial diagnosis or commencing treatment was 53 months on the average. There was no case of major adverse cardiac events such as cardiac death or myocardial infarction during the periods.

Keyword

Coronary artery disease; Civil aviation workers