The underlying mechanisms of cold exposure-induced ischemic stroke

Chen, Zhuangzhuang; Liu, Peilin; Xia, Xiaoshuang; Wang, Lin; Li, Xin

doi:10.1016/j.scitotenv.2022.155514

Cited by 22 publications

(9 citation statements)

References 109 publications

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“…33 The underlying mechanism may involve cerebrovascular stress induced by cold, influencing blood platelet aggregation, red cell dynamics, and viscosity alterations, thereby facilitating vasoconstriction and blood clotting. 34,35…”

Section: Discussionmentioning

confidence: 99%

Global, Regional, and National Burdens of Stroke in Children and Adolescents From 1990 to 2019: A Population-Based Study

Sun,

Ma,

Jin

et al. 2024

Stroke

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BACKGROUND: Stroke is one of the leading causes of death among children, yet evidence on stroke incidence and prognosis in this population is largely neglected worldwide. The aim of this study was to estimate the latest burden of childhood stroke, as well as trends, risk factors, and inequalities from 1990 to 2019, at the global, regional, and national levels. METHODS: The Global Burden of Disease 2019 study was utilized to evaluate the prevalence, incidence, years lived with disability, years of life lost (YLLs), and average annual percentage changes in stroke among populations aged 0 to 19 years from 1990 to 2019. RESULTS: The global age–standardized incidence of stroke increased (average annual percentage change, 0.15% [95% uncertainty interval, 0.09%–0.21%]), while YLLs decreased substantially (average annual percentage change, −3.33% [95% uncertainty interval, −3.38% to −3.28%]) among children and adolescents between 1990 and 2019. Ischemic stroke accounted for 70% of incident cases, and intracerebral hemorrhage accounted for 63% of YLLs. Children under 5 years of age had the highest incidence of ischemic stroke, while adolescents aged 15 to 19 years had the highest incidence of hemorrhagic stroke. In 2019, low-income and middle-income countries were responsible for 84% of incident cases and 93% of YLLs due to childhood stroke. High-sociodemographic index countries had a reduction in YLLs due to stroke that was more than twice as fast as that of low-income and middle-income. CONCLUSIONS: Globally, the burden of childhood stroke continues to increase, especially among females, children aged <5 years, and low-sociodemographic index countries, such as sub-Saharan Africa. The burden of childhood stroke is likely undergoing a significant transition from being fatal to causing disability. Global public health policies and the deployment of health resources need to respond rapidly and actively to this shift.

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Section: Discussionmentioning

confidence: 99%

Global, Regional, and National Burdens of Stroke in Children and Adolescents From 1990 to 2019: A Population-Based Study

Sun,

Ma,

Jin

et al. 2024

Stroke

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“…This was consistent with findings from previous studies across diverse climatic zones globally. [4][5][6][25][26][27] A retrospective analysis of hospital data in the United States revealed a surge in stroke admissions during winter, accompanied by increased mortality rates. 4 Ambulance dispatches for ischemic stroke cases in Japan exhibited a similar seasonal pattern and were observed to be more common during lower temperatures.…”

Section: Discussionmentioning

confidence: 99%

Machine learning-based forecasting of daily acute ischemic stroke admissions using weather data

Santhanam,

Kim,

Rügamer

et al. 2024

Preprint

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BackgroundIn the midst of the emerging climate crisis, healthcare providers lack locally validated, disease-specific surveillance models. Stroke, a significant contributor to the global disease burden, has been linked to climate change. Therefore, we developed and benchmarked machine learning (ML) models based on locoregional weather systems to forecast the number of daily acute ischemic stroke (AIS) admissions.MethodsAIS patients diagnosed between 2015 and 2021 at the tertiary University Medical Center (UMC) Mannheim, Germany were extracted from the local data integration center and geospatially matched to weather data from the German Weather Service (DWD) based on the clinic’s, patients’ home and closest tower’s locations at the time of admission. Statistical- (Poisson), boosted generalized additive model (GAM), support vector machines (SVR), and tree-based models including random forest (RF) and extreme gradient boosting (XGB) were evaluated in regression settings within time-stratified nested cross-validation setup (training-validation: 2015-2020, test set: 2021) to predict the number of daily AIS admissions.FindingsThe cohort included 7,914 AIS patients (4,244 male, 53·6%). XGB showed the best test performance with lowest mean absolute error (MAE) of 1·21 cases/day. Maximum air pressure was identified as the top predictive variable. Shapley additive explanations analyses revealed that temperature extremes of extended cold-(lag-3 minimum temperature <-2 °C; minimum perceived temperature <-1·4 °C) and hot stressors (lag-7 minimum temperature >15 °C), as well as stormy conditions (lag-1 and lag-2 maximum wind gust >14 m/s and speed >10·4 m/s), increased stroke incidences substantially with distinct seasonal associations.InterpretationML models can sufficiently forecast AIS admissions based on weather patterns allowing for improved resource allocation and preparedness.

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“…Moreover, patients with diabetes were more prone to cold-related cardiovascular disease ( 38 ). Similarly, cold exposure impacted lipid metabolism disorder and influenza epidemics ( 39 ) and may induce more fat and alcohol intake.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of cold exposure and cardiovascular disease outcomes

Fan

Xiao

Feng

et al. 2023

Front. Cardiovasc. Med.

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BackgroundCold exposure has been considered an essential risk factor for the global disease burden, while its role in cardiovascular diseases is still underappreciated. The increase in frequency and duration of extreme cold weather events like cold spells makes it an urgent task to evaluate the effects of ambient cold on different types of cardiovascular disease and to understand the factors contributing to the population's vulnerability.MethodsIn the present systematic review and meta-analysis, we searched PubMed, Scopus, and Cochrane. We included original research that explored the association between cold exposure (low temperature and cold spell) and cardiovascular disease outcomes (mortality and morbidity). We did a random-effects meta-analysis to pool the relative risk (RR) of the association between a 1°C decrease in temperature or cold spells and cardiovascular disease outcomes.ResultsIn total, we included 159 studies in the meta-analysis. As a result, every 1°C decrease in temperature increased cardiovascular disease-related mortality by 1.6% (RR 1.016; [95% CI 1.015–1.018]) and morbidity by 1.2% (RR 1.012; [95% CI 1.010–1.014]). The most pronounced effects of low temperatures were observed in the mortality of coronary heart disease (RR 1.015; [95% CI 1.011–1.019]) and the morbidity of aortic aneurysm and dissection (RR 1.026; [95% CI 1.021–1.031]), while the effects were not significant in hypertensive disease outcomes. Notably, we identified climate zone, country income level and age as crucial influential factors in the impact of ambient cold exposure on cardiovascular disease. Moreover, the impact of cold spells on cardiovascular disease outcomes is significant, which increased mortality by 32.4% (RR 1.324; [95% CI 1.2341.421]) and morbidity by 13.8% (RR 1.138; [95% CI 1.015–1.276]).ConclusionCold exposure could be a critical risk factor for cardiovascular diseases, and the cold effect varies between disease types and climate zones.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022347247.

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The underlying mechanisms of cold exposure-induced ischemic stroke

Cited by 22 publications

References 109 publications

Global, Regional, and National Burdens of Stroke in Children and Adolescents From 1990 to 2019: A Population-Based Study

Global, Regional, and National Burdens of Stroke in Children and Adolescents From 1990 to 2019: A Population-Based Study

Machine learning-based forecasting of daily acute ischemic stroke admissions using weather data

A systematic review and meta-analysis of cold exposure and cardiovascular disease outcomes

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