Stress Test on the Prediction of Cardiovascular Events in a High-risk Firefighter Population

Study Overview
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Brief Summary
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If the risk of myocardial infarction in activity is widely demonstrated to date for firefighters, and the realization of a stress test in those at high cardiovascular risk included in the practice habits, no study has evaluated the contributions and limits of the realization of a stress test in this specific population of firefighters at high cardiovascular risk for the prediction of cardiovascular events.

Detailed Description
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The professional practice of firefighting presents risks specific, especially cardiovascular. In the United States 30% of Firefighter deaths are the result of a myocardial infarction that occurred while on duty. Certain occupational tasks expose firefighters to a higher risk of myocardial infarction (high physical load, inhalation of products). There is no recommendation on how to assess cardiovascular risk in French firefighters. In the absence of consensus, the Loire Departmental Fire and Rescue Service has constructed a scale for collecting cardiovascular risk factors (expert working group) to identify firefighters at high cardiovascular risk. A maintenance visit (mandatory every two years until the age of 38 and then once a year) is the best way to assess this cardiovascular risk, with a biological assessment and an electrocardiogram after the age of 40. If cardiovascular risk factors are present and the cardiovascular risk is high, the resting electrocardiogram should be supplemented by an exercise test. An exercise test can directly or indirectly quantify the endurance capacities of firefighters and reveal cardiac abnormalities sometimes absent at rest. Half of all myocardial infarctions occur without any prior symptomatology and remain totally asymptomatic, discovered during routine examinations. If the risk of myocardial infarction in activity is widely demonstrated to date for firefighters, and the realization of a stress test in those at high cardiovascular risk included in the practice habits, no study has evaluated the contributions and limits of the realization of a stress test in this specific population of firefighters at high cardiovascular risk for the prediction of cardiovascular events.

Official Title
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Contributions and Limitations of the Stress Test on the Prediction of Cardiovascular Events in a High-risk Firefighter Population

Conditions
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High Cardiovascular Risk, Firefighter

Intervention / Treatment
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* Other: stress test


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any professional or volunteer firefighter with a high cardiovascular risk attached to the Departmental Fire and Rescue Service of the Loire who has carried out an effort test between 2006 and 2014. Subject who received informed oral information about the study by telephone and agreed to participate in the study Exclusion Criteria: Subject unable to understand the study Subject matter subject to a legal protection measure

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Firefighter<br>Firefighter with high cardiovascular risk | Other: stress test<br>* endurance capacity<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiovascular morbidity | determined by occurrence of: Cardiovascular death; Myocardial infarction; stroke; Arteriopathy; Atrial fibrillation | Between 2006 and 2014 | 
| Cardiovascular mortality | determined by occurrence of: Cardiovascular death; Myocardial infarction; stroke; Arteriopathy; Atrial fibrillation | Between 2006 and 2014 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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firefighter, high cardiovascular risk, stress tests