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Volume 6 Issue 2
Apr.  2026
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Article Navigation >  Frigid Zone Medicine  > 2026  >  6(2): 65-75
Sizheng Peng, Kai Du, Hongyan Zhao, Yingtao Zhang, Ruiyi Chen, Haiyu Zhang, Kai Dong, Hongxin Xu, Yue Li, Leilei Yin, Yuhui Sun, Tao Song. Association between ambient temperature variability and ST-segment elevation myocardial infarction in cold regions, China: A time-series analysis[J]. Frigid Zone Medicine, 2026, 6(2): 65-75. doi: 10.1515/fzm-2026-0007
Citation: Sizheng Peng, Kai Du, Hongyan Zhao, Yingtao Zhang, Ruiyi Chen, Haiyu Zhang, Kai Dong, Hongxin Xu, Yue Li, Leilei Yin, Yuhui Sun, Tao Song. Association between ambient temperature variability and ST-segment elevation myocardial infarction in cold regions, China: A time-series analysis[J]. Frigid Zone Medicine, 2026, 6(2): 65-75. doi: 10.1515/fzm-2026-0007
shu

Association between ambient temperature variability and ST-segment elevation myocardial infarction in cold regions, China: A time-series analysis

doi: 10.1515/fzm-2026-0007
  • 1.

    Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China

  • 2.

    Department of Cardiology, Rizhao International Heart Hospital, Rizhao 276800, China

  • 3.

    Department of Medical Record, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China

  • 4.

    School of Computer Science and Technology, Harbin Institute of Technology, Harbin 150001, China

  • 5.

    Department of Cardiology, Harbin Fourth Hospital, Harbin 150026, China

Funds:

the Key Project of Natural Science Foundation of Heilongjiang Province ZL2024H002

the Key research and development program of Heilongjiang Province 2023ZX02C10

the Heilongjiang Postdoctoral Research Foundation LBH-Q20110

More Information
    Abstract
  •   Objective  This study investigated the impact of daily ambient temperature and temperature changes between neighboring days (TCN) on the risk of ST-segment elevation myocardial infarction (STEMI) in cold regions using a time-series approach.  Methods  From January 1, 2017 to December 31, 2020, STEMI cases were collected from the largest medical center in Heilongjiang Province, excluding patients with incomplete data or unclear symptom onset times. Meteorological variables and air pollutant data corresponding to patients' residential address were matched from nearby monitoring stations. A distributed lag nonlinear model (DLNM) with a lag period of 0-21 days was applied to assess the effects of suboptimal temperatures on STEMI risk and lag structures. Different temperature indicators (maximum, mean, minimum, and TCN) were compared, and subgroup analyses by sex and age were performed to evaluate population-specific susceptibility.  Results  A total of 1461 days were included, comprising 4700 STEMI cases. Cold exposure was associated with a significant increase in STEMI incidence, with a delayed onset of 3 days and a prolonged effect lasting up to 20 days. In contrast, the heat effect was immediate and persisted for approximately 3 days. In the 21-day cumulative relative risk (CRR) analysis, using a median temperature of 6.6 ℃, the minimum morbidity temperature was identified at 17 ℃ (CRR 0.709, 95% CI 0.345-1.457). Notably, the highest incidence did not occur at the lowest temperature (-29 ℃, CRR 1.201, 95% CI 0.273-5.273). Instead, STEMI risk increased as temperatures rose from extreme cold, reaching a peak at -10 ℃ (CRR 1.63, 95% CI 0.905-2.936). Under conditions of extreme cooling (TCN = -11 ℃), STEMI risk increased from lag 0 to 7 (relative risk [RR] 2.239, 95% CI 0.279-17.936).  Conclusions  In cold regions, extreme temperatures, especially sustained cold exposure, significantly increase the risk of STEMI. Rapid temperature drops between consecutive days further elevate incidence, highlighting the importance of both absolute temperature and short-term temperature variability in cardiovascular risk.

     

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