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Upward air temperature shifts and acute cardiovascular events in individuals with atherosclerotic cardiovascular disease: A time-stratified case-crossover study.
Lancet Reg. Health-Eur. 67:101730 (2026)
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Forschungsdaten
DOI
ackground Global warming is an increasing health concern. While the health impact of heat has been widelystudied, the effects of transient temperature fluctuations remain largely unknown. Here we evaluated the impact ofupward air temperature shifts (uTS) on acute cardiovascular events and mortality in individuals with atheroscleroticcardiovascular disease (ASCVD).Methods This time-stratified case-crossover study included 1,315,553 patients with ASCVD from a German healthinsurance between 2012 and 2020. Daily mean outside temperatures was estimated on a 1 × 1 km grid and, togetherwith daily counts for acute coronary syndrome (ACS; n = 126,193), stroke (n = 154,122), hospitalizations for heartfailure (n = 356,053), and all-cause mortality (n = 345,907), aggregated at the 3-digit postcode level. uTS was definedas days when mean air temperature exceeded the preceding seven-day average. Conditional Poisson regression wasused to estimate acute and lagged associations, adjusting for time-varying confounders; area-specific estimates werepooled using multivariate meta-analysis.Findings A 5 ◦C increase in uTS (observed on 185 days during the study period; 21 days/year), was associated with ahigher risk for ACS (relative risk [RR] 1.03; 95% confidence interval [CI], 1.02–1.04), stroke (RR 1.02; 95% CI,1.01–1.03), hospitalization for heart failure (RR 1.01; 95% CI, 1.01–1.02), and all-cause mortality (RR 1.03; 95% CI,1.02–1.04). Associations were more pronounced during the warm season. The mean number of deaths attributableto uTS was 23 per 100,000 participants per year (95% CI, 18–29).Interpretation Exposure to upward temperature shifts was associated with higher risks of ACS, stroke, hospitali-zations for heart failure, as well as all-cause mortality in individuals with ASCVD. This was not fully explained byheat per se. Public health action is warranted, given the projected increase in temperature variability with climatechange.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Heart Failure ; Stroke (engine) ; Confidence Interval ; Poisson Regression ; Cardiovascular Health ; Atherosclerosis Risk In Communities ; Acute Coronary Syndrome ; Heat Wave ; Air Temperature
ISSN (print) / ISBN
2666-7762
e-ISSN
2666-7762
Zeitschrift
The Lancet Regional Health - Europe
Quellenangaben
Band: 67,
Artikelnummer: 101730
Verlag
Elsevier
Begutachtungsstatus
Peer reviewed
Institut(e)
Institute of Epidemiology (EPI)