Association of Daily Mean Temperature and Temperature Variability With Onset Risks of Acute Aortic Dissection

Abstract

Background The association between ambient temperature and cardiovascular diseases has been well established, but evidence of temporal changes in the risk of acute aortic dissection (AAD) onset is lacking. Methods and Results We conducted an 8‐year time‐series study based on data from 2120 patients diagnosed with AAD at Tongji Hospital (Wuhan, China). Daily meteorological parameters were measured in the study area. Spearman's rank correlation analysis was applied to measure the associations between daily meteorological data and air pollution indicators. A distributed lag nonlinear model following quasi‐Poisson regression was used to express the nonlinear exposure‐response relationships and lag effects of daily mean temperature and temperature variability on the occurrence of AAD. Considering a 25‐day lag effect, lower or higher temperatures with reference to 25°C did not alter the onset risk of AAD. The lag effect of daily mean temperature on the incidence of AAD is statistically significant within 2 days, and the impact of daily mean temperature on the risk is most influential on the day. The exposure‐response curve between daily mean temperature and onset risks of AAD at lag 0 showed that the extremely cold temperature (2.5th percentile, 0.5°C) significantly increased the AAD risk for the total (relative risk, 1.733; 95% CI, 1.130–2.658) and type A dissection (relative risk, 3.951; 95% CI, 1.657–9.418). Temperature variability within 1 week did not affect the onset risks of AAD for the total. Conclusions We confirmed that extremely cold temperatures significantly increased the AAD risk, which could contribute to early prevention and timely diagnosis of the disease.

Low temperature and temperature decline increase acute aortic dissection risk and burden: A nationwide case crossover analysis at hourly level among 40,270 patients

“…Nevertheless, the overall trend of the associations between cold weather and AAD onset in our study were consistent with previous ones. 5 , 6 , 9 , 10 , 24 In addition to low ambient temperature, we found temperature decline between two neighboring days was also associated with higher AAD onset. To the best of our knowledge, only one previous study has examined the associations of AAD onset with TCN besides absolute temperature, and the findings were consistent with ours.…”

“… 6 , 7 , 8 , 9 Moreover, all previous studies lack the sub-daily information of AAD onset and therefore only examined the associations on a daily basis, which might attenuate the causality due to the unclear chronological order of exposure and events within the same day. 6 , 9 , 10 As the onset of AAD fluctuates greatly during 24-hours throughout a day, it is therefore critically important to evaluate the association between temperature and AAD onset at hourly level. In addition, AAD can be classified into type A (which occurs in the ascending aorta) and type B (which occurs in the descending aorta and distal arteries) based on the Stanford classification, which varied in symptoms, anatomical location, and fatality rate and thus might have different risk factors.…”

The cold effect of ambient temperature on acute aortic dissection hospital admission: utilizing distributed lag nonlinear analysis

“…Compared with existing studies, in the work of Yu et al, they found that extremely low ambient temperature is positively associated with the onset of AAD (Yu et al, 2021). In a study between incidence of AAD and climatic factors, it was found that the frequency of AAD reached its peak in winter (Ma et al, 2020).…”

“…The incidence rate of AAD was the highest in winter and the lowest in summer (Xia et al, 2020). A study has found that a low temperature environment can increase the risk of AAD (Yu et al, 2021), and a signi cant association between cold temperature and the AAD was discovered by a linear regression analysis (Sadamatsu et al, 2020). Seasonal variation suggests that ambient temperature may be an important environmental risk factor for AAD.…”

Temperature effects on incidence of surgery for acute type A aortic dissection in the Nordics

“…These studies were limited by small study samples and show conflicting results [ 14–19 ]. Recently, however, two large studies using advanced statistical methods reported increased risk of acute aortic dissection at lower temperatures [ 20 , 21 ].…”