Associations of apparent temperature with acute cardiac events and subtypes of acute coronary syndromes in Beijing, China

The impact of apparent temperature on the emergency visits for traumatic fractures in Hangzhou, China

BACKGROUND

Traumatic fractures occur frequently worldwide. However, research remains limited on the association between short-term exposure to temperature and traumatic fractures. This study aims to explore the impact of apparent temperature (AT) on emergency visits (EVs) due to traumatic fractures.

METHODS

Based on EVs data for traumatic fractures and the contemporary meteorological data, a generalized Poisson regression model along with a distributed lag nonlinear model (DLNM) were undertaken to determine the impact of AT on traumatic fracture EVs. Subgroup analysis by gender and age and sensitivity analysis were also performed.

RESULTS

A total of 25,094 EVs for traumatic fractures were included in the study. We observed a wide "J"-shaped relationship between AT and risk of traumatic fractures, with AT above 9.5 °C positively associated with EVs due to traumatic fractures. The heat effects became significant at cumulative lag 0-11 days, and the relative risk (RR) for moderate heat (95th percentile, 35.7 °C) and extreme heat (99.5th percentile, 38.8 °C) effect was 1.311 (95% CI: 1.132-1.518) and 1.418 (95% CI: 1.191-1.688) at cumulative lag 0-14 days, respectively. The cold effects were consistently non-significant on single or cumulative lag days across 0-14 days. The heat effects were higher among male and those aged 18-65 years old. The sensitivity analysis results remained robust.

CONCLUSION

Higher AT is associated with cumulative and delayed higher traumatic fracture EVs. The male and those aged 18-65 years are more susceptible to higher AT.

Exploring the relationship between land use/land cover and apparent temperature in China (1996-2020): implications for urban planning

In recent decades, rising air temperatures (AT) and apparent temperatures (AP) have posed growing health risks. In the context of China's rapid urbanization and global climate change, it is crucial to understand the impact of urban land use/land cover (LULC) changes on AP. This study investigates the spatial distribution and long-term variation patterns of AT and AP, using data from 834 meteorological stations across China from 1996 to 2020. It also explores the relationship between AT, AP, and LULC in the urban core areas of 30 major cities. Study reveals that AT and AP exhibit overall high spatial similarity, albeit with greater spatial variance in AP. Notably, regions with significant disparities between the two have been identified. Furthermore, it's observed that the spatial range of high AP change rates is wider than that of AT. Moreover, the study suggests a potential bivariate quadratic function relationship between ΔT (the difference between AT and AP) and Wa_ratio and Ar_ratio, indicating the presence of a Least Suitable Curve (LSC), [Formula: see text]. Urban LULC planning should carefully avoid intersecting with this curve. These findings can provide valuable insights for urban LULC planning, ultimately enhancing the thermal comfort of urban residents.

Heatwave Definition and Impact on Cardiovascular Health: A Systematic Review

Objectives: We aimed to analyze recent literature on heat effects on cardiovascular morbidity and mortality, focusing on the adopted heat definitions and their eventual impact on the results of the analysis. Methods: The search was performed on PubMed, ScienceDirect, and Scopus databases: 54 articles, published between January 2018 and September 2022, were selected as relevant. Results: In total, 21 different combinations of criteria were found for defining heat, 12 of which were based on air temperature, while the others combined it with other meteorological factors. By a simulation study, we showed how such complex indices could result in different values at reference conditions depending on temperature. Heat thresholds, mostly set using percentile or absolute values of the index, were applied to compare the risk of a cardiovascular health event in heat days with the respective risk in non-heat days. The larger threshold's deviation from the mean annual temperature, as well as higher temperature thresholds within the same study location, led to stronger negative effects. Conclusion: To better analyze trends in the characteristics of heatwaves, and their impact on cardiovascular health, an international harmonization effort to define a common standard is recommendable.

Door to Balloon Time of Non-ST Elevation Myocardial Infarction May be Reconsidered According to Systemic Immune-Inflammation Index

Aim    Early diagnosis and treatment is very important in acute coronary syndromes (ACS). Previous studies showed that not all non-ST elevation myocardial infarction (NSTEMI) patients should be considered and treated in the same way. The systemic immune-inflammation index (SII), which is an easily accessible, rapidly computed, and cost-effective parameter, was evaluated in this study to determine the optimal intervention time for NSTEMI.Material and methods    469 patients diagnosed with ACS were included to the study. STEMI and NSTEMI patients were compared according to their SII. Univariate and binary logistic regression analysis were performed to determine which parameters have a significant effect on the discrimination of types of myocardial infarction.Results    The mean age of the patients was 61.43±11.52 yrs, and 348 (74.2 %) were male. NSTEMI patients with an SII value higher than 768×109 / l may be assumed to be STEMI (p<0.001). Univariate analysis and binary logistic regression showed that only SII and hypertension had statistically impact on differentiation of STEMI and NSTEMI. In addition, SII value of 1105×109 / l was the cut-off point for discrimination of cardiovascular survival (p<0.001, AUC =0.741). This study was performed to find out which NSTEMI patients should be treated percutaneously immediately after first medical contact according to SII. It was found that, SII value of higher than 768×109 / l is related with STEMI.Conclusion    In conclusion, NSTEMI patients with a SII value higher than 768×109 / l may be considered as STEMI and treated with in 120 min after first contact. In addition, SII was found to be a cardiovascular mortality predictor after myocardial infarction, and this may be used for identifying high-risk patients after percutaneous coronary intervention.

Short-term effects of air pollution and weather changes on the occurrence of acute aortic dissection in a cold region

Background

Air pollution and severe weather conditions can adversely affect cardiovascular disease emergencies. Nevertheless, it remains unclear whether air pollutants and low ambient temperature can trigger the occurrence of acute aortic dissection (AAD) in cold regions.

Methods

We applied a retrospective analysis to assess the short-term effects of air pollution and ambient temperature on the occurrence of AAD in Harbin, China. A total of 564 AAD patients were enrolled from a major hospital in Harbin between January 1, 2017, and February 5, 2021. Weather condition data and air pollutant concentrations, including fine particulate matter smaller than 10 μm (PM10) and 2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3), were collected every day. Conditional logistic regressions and correlation analysis were applied to analyze the relationship of environmental and atmospheric parameters with AAD occurrence at lags of 0 to 7 days. Specifically, we appraised the air quality index, CO, NO2, SO2, O3, PM10, PM2.5, temperature, dew point temperature, atmospheric pressure, and cloud amount.

Results

A total of 1,496 days at risk were assessed, of which 564 patients developed AAD. Specifically, AAD did not occur on 1,043 (69.72%) days, while 1 or more cases occurred on 453 (30.28%) days. Several pollution and weather predictors for AAD were confirmed by multilevel modeling. The air quality index (p = 0.0012), cloud amount (p = 0.0001), and concentrations of PM2.5 (p = 0.0004), PM10 (p = 0.0013), NO2 (p = 0.0007) and O3 (p = 0.0001) predicted AAD as early as 7 days before the incident (lag of 7 days) in the study period. However, only concentrations of the air pollutants NO2 (p = 0.0468) and O3 (p = 0.011) predicted the occurrence of AAD after the COVID-19 outbreak. Similar predictive effects were observed for temperature, dew point temperature, and atmospheric pressure (all p < 0.05) on all days.

Conclusion

The risk of AAD is closely related to air pollution and weather characteristics in Harbin. While causation was not determined, the impact of air pollutants on the risk of AAD was reduced after the COVID-19 outbreak.

The Impact of Meteorological Factors and Air Pollutants on Acute Coronary Syndrome

Purpose of Review

Several studies have found that air pollution and climate change can have an impact on acute coronary syndromes (ACS), the leading cause of death worldwide. We synthesized the latest information about the impact of air pollution and climate change on ACS, the latest data about the pathophysiological mechanisms of meteorological factors and atmospheric pollutants on atherosclerotic disease, and an overall image of air pollution and coronary heart disease in the context of the COVID-19 pandemic.

Recent Findings

The variation of meteorological factors in different seasons increased the risk of ACS. Both the increase and the decrease in apparent temperature were found to be risk factors for ACS admissions. It was also demonstrated that exposure to high concentrations of air pollutants, especially particulate matter, increased cardiovascular morbidity and mortality.

Summary

Climate change as well as increased emissions of air pollutants have a major impact on ACS. The industrialization era and the growing population cause a constant increase in air pollution worldwide. Thus, the number of ACS favored by air pollution and the variations in meteorological factors is expected to increase dramatically in the next few years.

Clustering of Environmental Parameters and the Risk of Acute Myocardial Infarction

The association between days with similar environmental parameters and cardiovascular events is unknown. We investigate the association between clusters of environmental parameters and acute myocardial infarction (AMI) risk in Singapore. Using k-means clustering and conditional Poisson models, we grouped calendar days from 2010 to 2015 based on rainfall, temperature, wind speed and the Pollutant Standards Index (PSI) and compared the incidence rate ratios (IRR) of AMI across the clusters using a time-stratified case-crossover design. Three distinct clusters were formed with Cluster 1 having high wind speed, Cluster 2 high rainfall, and Cluster 3 high temperature and PSI. Compared to Cluster 1, Cluster 3 had a higher AMI incidence with IRR 1.04 (95% confidence interval 1.01–1.07), but no significant difference was found between Cluster 1 and Cluster 2. Subgroup analyses showed that increased AMI incidence was significant only among those with age ≥65, male, non-smokers, non-ST elevation AMI (NSTEMI), history of hyperlipidemia and no history of ischemic heart disease, diabetes or hypertension. In conclusion, we found that AMI incidence, especially NSTEMI, is likely to be higher on days with high temperature and PSI. These findings have public health implications for AMI prevention and emergency health services delivery during the seasonal Southeast Asian transboundary haze.

Study on the Associations between Meteorological Factors and the Incidence of Pulmonary Tuberculosis in Xinjiang, China

Pulmonary tuberculosis (PTB) has been a major threat to global public health. The association between meteorological factors and the incidence of PTB has been widely investigated by the generalized additive model, auto-regressive integrated moving average model and the distributed lag model, etc. However, these models could not address a non-linear or lag correlation between them. In this paper, a penalized distributed lag non-linear model, as a generalized and improved one, was applied to explore the influence of meteorological factors (such as air temperature, relative humidity and wind speed) on the PTB incidence in Xinjiang from 2004 to 2019. Moreover, we firstly use a comprehensive index (apparent temperature, AT) to access the impact of multiple meteorological factors on the incidence of PTB. It was found that the relationships between air temperature, relative humidity, wind speed, AT and PTB incidence were nonlinear (showed “wave-type “, “invested U-type”, “U-type” and “wave-type”, respectively). When air temperature at the lowest value (−16.1 °C) could increase the risk of PTB incidence with the highest relative risk (RR = 1.63, 95% CI: 1.21–2.20). An assessment of relative humidity demonstrated an increased risk of PTB incidence between 44.5% and 71.8% with the largest relative risk (RR = 1.49, 95% CI: 1.32–1.67) occurring at 59.2%. Both high and low wind speeds increased the risk of PTB incidence, especially at the lowest wind speed 1.4 m/s (RR = 2.20, 95% CI: 1.95–2.51). In particular, the lag effects of low and high AT on PTB incidence were nonlinear. The lag effects of extreme cold AT (−18.5 °C, 1st percentile) on PTB incidence reached a relative risk peak (RR = 2.18, 95% CI: 2.06–2.31) at lag 1 month. Overall, it was indicated that the environment with low air temperature, suitable relative humidity and wind speed is more conducive to the transmission of PTB, and low AT is associated significantly with increased risk of PTB in Xinjiang.