Secondary prevention medication and test outcomes of sixteen military aircrews with coronary heart disease after percuteneous coronary artery stents

WANG Xiaotong; ZHANG Haitao; HUANG Congchun; ZHENG Jun; YANG Zhihui; WANG Jianchang

Abstract：Objective To study the medication for secondary prevention after percuteneous coronary artery stents in military aircrews with coronary heart disease (CHD), and principles and methods of aero-medical assessment.Methods Sixteen aircrews were selected as subjects. The types of medicine for secondary prevention, medication compliance,and results of testing including treadmill exercise test, myocardial perfusion imaging, computed tomography coronary angiography and coronary angiography in these aircrews were restrospectively analyzed. These aviators were followed up to establish the principles of aero-medical assessment.Results Among the sixteen aircrews, there were six cases of latent coronary heart disease, five cases of acute myocardial infarction and five cases with unstable angina. They were all treated with percuteneous coronary artery stents. After 6 to 20 months of follow-up, nine cases were permitted to resume flight. Their ventricular wall motion and systolic function were normal. Among them, there were two cases whose treadmill exercise test was positive, and one of them was diagnosed with lesion stenosis in computed tomography coronary angiography. The treadmill exercise test of seven cases was negative. Three of them received computed tomography coronary angiography, two of whom were diagnosed with lesion stenosis. All of them were normal with coronary angiography. The remaining seven aviators did not meet the criteria for waiver consideration, including one case with instent restenosis, two with noninvasive testing evidence of reversible ischemia, three with lesions stenosis, and one case who was treated percuteneous coronary artery stents a second time. After stent implantation, they were regularly treated with statins and antiplatelets, and all of them had good compliance.Conclusion After evaluation of medication for secondary prevention and invasive and noninvasive test which show good cardiovascular function, military aviators can return to flight with revascularization by stents. Military aviators for initial waiver consideration will complete noninvasive testing and follow-up coronary angiography.