Background   Previous studies have established a link between fluctuations in climate and increased mortality due to coronary artery disease (CAD). However, there remains a need to explore and clarify the evidence for associations between meteorological changes and hospitalization incidences related to CAD and its subtypes, especially in cold regions. This study aimed to systematically investigate the relationship between exposure to meteorological changes, air pollutants, and hospitalization for CAD in cold regions.   Methods   We conducted a cross-sectional study using hospitalization records of 86, 483 CAD patients between January 1, 2009, and December 31, 2019. Poisson regression analysis, based on generalized additive models, was applied to estimating the influence of hospitalization for CAD.   Results   Significant associations were found between low ambient temperature [-10℃, RR= 1.65; 95% CI: (1.28–2.13)] and the incidence of hospitalization for CAD within a lag of 0–14 days. Furthermore, O₃ [95.50 μg/m³, RR = 12; 95% CI: (1.03–1.21)] and NO₂ [48.70 μg/m³, RR = 1.0895% CI: (1.01–1.15)] levels were identified as primary air pollutants affecting the incidence of CAD, ST-segment-elevation myocardial infarction (STEMI), and non-STEMI (NSTEMI) within the same lag period. Furthermore, O₃ [95.50 μg/m³, RR = 1.12; 95% CI: (1.03–1.21)] and NO₂ [48.70 μg/m³, RR = 1.0895% CI: (1.01–1.15)] levels were identified as primary air pollutants affecting the incidence of CAD, ST-segment-elevation myocardial infarction (STEMI), and non-STEMI (NSTEMI) within the same lag period. The effect curve of CAD hospitalization incidence significantly increased at lag days 2 and 4 when NO₂ and O₃ concentrations were higher, with a pronounced effect at 7 days, dissipating by lag 14 days. No significant associations were observed between exposure to PM, SO₂, air pressure, humidity, or wind speed and hospitalization incidences due to CAD and its subtypes.   Conclusion   Our findings suggest a positive correlation between short-term exposure to low ambient temperatures or air pollutants (O₃ and NO₂) and hospitalizations for CAD, STEMI, and NSTEMI. These results could aid the development of effective preparedness strategies for frequent extreme weather events and support clinical and public health practices aimed at reducing the disease burden associated with current and future abnormal weather events.

Climate is one of the environmental conditions on which people live. Climate conditions impact every aspect of people's daily life and production activities, even the survival of humankind. In recent years, human activities have adversely changed the climate. The emergence of global warming and extreme weather has prompted people to pay attention to the impact of climate on life. The adverse climate issues include reduced quality of air and food, facilitated spread of diseases and increased mortality of the population. Being more orientated to climate changes in the past, research has been less alerted to the negative impacts that climate changes could bring to human health. This could be ascribed to that after living in a region for a long time, the human body has "adapted" to climate. And after adaptation, routine health outcomes such as disease incidence and hospitalization rate become less obvious, making the habitants blind from the undesirable impacts of climate on the health status. This review article summarizes the impacts of cold climate on human development, including maternal/fetal factors, lifestyle factors, etc., and delineates the relationship between cold climate and human health.