Table 1

Coronary artery disease classifications for aeromedical disposition

Stenosis (%)FFRAnnual MACE (%)Pilot aircrew dispositionNon-pilot aircrew disposition*
Haemodynamically significant≥70<0.8>3.0Grounded†Grounded†
Single vessel obstructive
(non-haemodynamically significant)
50–69>0.81.0–3.0With restrictions‡§Unrestricted possible‡§*
Single vessel non-obstructive30–49>0.81.0–3.0With restrictions‡Unrestricted possible*
Luminal irregularitiesUp to 30>0.80.5–1Unrestricted possible‡Usually unrestricted ‡*
Aggregate stenosis: severe≥120N/A>3.0Grounded†With restrictions†*
Aggregate stenosis: moderate50–119N/A1.0–3.0With restrictions‡Unrestricted possible‡*
Aggregate stenosis: mild<50N/A0.5–1.5Unrestricted possible‡Unrestricted possible‡*
Left main stenosis: significant30–49N/A1.0–3.0With restrictions‡§Usually with restrictions‡§*
Left main stenosis≥50N/A>3.0Grounded†Grounded†
  • *Will depend on aircrew role and individual agency acceptable risk threshold.

  • †Without revascularisation; return to flight (in a limited capacity) may be possible after revascularisation.

  • ‡With aggressive risk factor modification and close follow-up, restricted return to flight duties may be possible depending on the risk threshold accepted by the individual aircrew’s respective regulatory authority.

  • §Wide discrepancy in disposition in difference agencies. Federal Aviation Administration would allow for flight duties with restrictions, European Aviation Safety Agency would permanently ground aircrew.

  • FFR, fractional flow reserve; MACE, major adverse cardiovascular event.