Association between heat stroke and ischemic heart disease: A national longitudinal cohort study in Taiwan

Tseng, Min Feng; Chou, Chu Lin; Chung, Chi Hsiang; Chien, Wu Chien; Chen, Ying Kai; Yang, Hsiu Chien; Chu, Pauling

doi:10.1016/j.ejim.2018.09.019

Cited by 15 publications

(15 citation statements)

References 33 publications

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“…As the body temperatures increases, the occurrence of HI-associated complications, including central nervous system dysfunction and additional organ damage including AKI, liver injury, and rhabdomyolysis, is gradually increasing [10]. Recently, a population-based study enrolling 628 patients in Taiwan suggested that ischemic heart disease was independently associated with heat stroke in a Cox multivariate regression analysis [11]. Another retrospective study enrolled patients aged >65 years from 114 cities in USA and revealed that the impact of high temperature and heat waves increased the hospitalizations for renal disease (including acute/chronic glomerulonephritis, nephrotic syndrome, acute/chronic renal failure) and respiratory diseases (including bronchiectasis and chronic airway obstruction) [12].…”

Section: Discussionmentioning

confidence: 99%

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Risk of chronic kidney disease in patients with heat injury: A nationwide longitudinal cohort study in Taiwan

et al. 2020

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Global climate change has led to a significant increase in temperature over the last century and has been associated with significant increases in the severity and frequency of heat injury (HI). The consequences of HI included dehydration and rhabdomyolysis, leading to acute kidney injury, which is now recognized as a clear risk factor for chronic kidney disease (CKD). We aimed to investigate the effects of HI on the risk of CKD. This nationwide longitudinal population-based retrospective cohort study utilized the Taiwan National Health Insurance Research Database (NHIRD) data. We enrolled patients with HI who were followed in NHIRD system between 2000 and 2013.We excluded patients diagnosed with CKD or genital-urinary system-related disease before the date of the new HI diagnosis. The control cohort consisted of individuals without HI history. The patients and control cohort were selected by 1:4 matching according to the following baseline variables: sex, age, index year, and comorbidities. The outcome measure was CKD diagnosis. In total, 815 patients diagnosed with HI were identified. During the 13 year observation period, we identified 72 CKD events (8.83%) in the heat stroke group and 143 (4.38%) CKD events in the control group. Patients with heat stroke had an increased risk of CKD than the control patients (adjusted HR = 4.346, P < 0.001) during the follow-up period. The risk of end-stage renal disease was also significantly increased in the heat stroke group than in the control group (adjusted hazards ratio: 9.078, p < 0.001). HI-related CKD may represent one of the first epidemics due to global warming. When compared to those without HI, patients with HI have an increased CKD risk.

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Section: Discussionmentioning

confidence: 99%

“…The study enrolled all patients diagnosed with HI (ICD-9-CM 992.X) in Taiwan. Data from the NHIRD in Taiwan were used in this study [6]. The association between heat stroke and CKD events was investigated between 2000 to 2013 period.…”

Section: Data Sourcementioning

confidence: 99%

Risk of chronic kidney disease in patients with heat injury: A nationwide longitudinal cohort study in Taiwan

et al. 2020

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“…Titles and abstracts of all 319 results were independently reviewed for relevance, and a total of 315 research papers were excluded due to the removal of duplicates and lack of outcomes of interest, i.e., cardiovascular disease, ischemic heart disease (IHD), heart failure (HF) or early death. Three relevant human studies were included in this review ( Table 1), in addition to one animal study investigating delayed myocardial metabolic dysfunction in mice post-EHS [16][17][18][19].…”

Section: Review Methods and Resultsmentioning

confidence: 99%

“…An interesting secondary observation was the significantly higher risk of IHD in female HS patients (8.4 fold) compared to their male counterparts (2.9 fold) (P < 0.001) [17] . Similar results were found in female mice in the later stages of recovery post-EHS, with significantly pronounced metabolic dysfunction and histological changes as compared to male mice post-EHS [19].…”

Section: Delayed Ischemic Heart Disease In Heatstroke Patientsmentioning

confidence: 97%

“…Laitano et al discovered various metabolic disorders including 1) accumulation of fatty acids and their reactive metabolites, ceramide and diacylglycerol (DAG), 2) glycolytic and tricarboxylic acid (TCA) pathway disturbances, 3) increased oxidative stress, and 4) extensive inflammation in myocardial cells [19] . Upon reviewing the literature, we found an increased risk of CVD in patients with a history of heatstroke, developing after initial recovery, as shown in Figure 1 [16][17][18]. Given the differences in incidence ( Figure 1) and underlying pathophysiology ( Figure 2) of IHD and heart failure, we will look at the two conditions separately.…”

Section: Delayed Cardiovascular Diseases In Heatstroke Patientsmentioning

confidence: 99%

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Long-Term Cardiovascular Diseases of Heatstroke: A Delayed Pathophysiology Outcome

Nzvere

Tariq

Nishanth

et al. 2020

Cureus

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Heatstroke, defined as an elevated core body temperature above 40°C accompanied by altered mental status (e.g., confusion, disorientation, seizure and coma), is the most severe and lifethreatening condition in the spectrum of heat-related illnesses. Heatstroke patients may present with multi-organ dysfunction, but with rapid cooling and organ failure management, a full recovery often occurs within weeks. Long-term impairment is rare, with neurological impairment occurring most frequently. Despite an abundance of research on the persistent neurological and hepatic impairments, our knowledge of the long-term cardiovascular events in patients with heatstroke history is poor. We wondered whether heatstroke leads to cardiovascular diseases long after full recovery. Using Pubmed, Web of Science and Scopus, we gathered cohort studies looking at cardiovascular disease incidence or mortality as an outcome, including heatstroke animal studies. Based on the available literature, we found that a history of heatstroke is associated with an increased risk of cardiovascular diseases, including ischemic heart disease, heart failure and atrial fibrillation. Delayed metabolic disturbances occurring in exertional heatstroke mice are linked to the formation of atherosclerosis and the development of heart failure. These processes provide potential pathophysiological pathways leading to ischemic heart disease and heart failure in heatstroke patients. Our findings may massively impact our understanding of heatstroke recovery and the follow up of heatstroke patients. Therefore larger, more adequately powered cohort studies with cardiovascular disease as an outcome, in tandem with animal studies examining the underlying pathophysiology, are required to confirm or reject these findings and answer the proposed questions.

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Gonadotropin‐releasing hormone agonist treatment and ischemic heart disease among female patients with breast cancer: A cohort study

et al. 2022

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Association between heat stroke and ischemic heart disease: A national longitudinal cohort study in Taiwan

Cited by 15 publications

References 33 publications

Risk of chronic kidney disease in patients with heat injury: A nationwide longitudinal cohort study in Taiwan

Risk of chronic kidney disease in patients with heat injury: A nationwide longitudinal cohort study in Taiwan

Long-Term Cardiovascular Diseases of Heatstroke: A Delayed Pathophysiology Outcome

Gonadotropin‐releasing hormone agonist treatment and ischemic heart disease among female patients with breast cancer: A cohort study

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