Optimizing Cardiovascular Screening in Polish Air Force Pilots with Coronary Artery Calcium Score

Abstract

Introduction: Coronary artery disease (CAD) is a major health concern in military aviation, representing one of the leading causes of flight disqualification. Traditional screening methods for CAD in military pilots include resting electrocardiograms and exercise stress tests, but these methods have limited sensitivity and specificity. This has prompted the search for more effective tools to assess cardiovascular risk and identify pilots at risk for CAD. One of the most promising tools in this regard is the Coronary Artery Calcium Score (CACS).

Methods: A comprehensive literature review was conducted using electronic databases, such as PubMed® and Google Scholar, focusing on the use of CACS in cardiovascular risk assessment, particularly in military populations. Relevant studies discussing the application of CACS in pilot screening protocols and clinical recommendations from aerospace medical regulatory bodies were included.

Results: The review highlights the advantages of using CACS over traditional screening tools, including its higher precision in evaluating cardiovascular risk and its ability to detect atherosclerotic lesions at an earlier stage. The findings also explore the potential of CACS to reduce the incidence of CAD-related flight disqualifications by improving early detection of disease among pilots.

Discussion: We discuss the current state of knowledge regarding the use of CACS in cardiovascular screening of military pilots and its potential to complement existing screening protocols. Finally, a diagnostic algorithm for incorporating CACS into the routine assessment of Polish Air Force pilots will be included, which may enhance the early detection of cardiac pathologies and improve flight safety. Kurek MA, Salacinska D, Rola M, Antoniak R. Optimizing cardiovascular screening in Polish Air Force pilots with coronary artery calcium score. Aerosp Med Hum Perform. 2025; 96(5):407-413.

Keywords: aviation medicine; cardiovascular risk; coronary artery calcium score; coronary artery disease; military aircrew.