Ambient Temperature and Cardiac Biomarkers: A Meta-Analysis

Abstract

This study quantified the effect of cold or heat exposure of ambient temperature on the alteration of well-known cardiac markers. A meta-analysis was performed using the PRISMA guidelines. Peer-reviewed studies on ambient temperature and cardiac biomarkers were retrieved from MEDLINE, ScienceDirect and Google Scholar from January 2000 to February 2022. The pooled effect sizes of ambient temperature on cardiac biomarkers c-reactive protein, soluble-cell adhesion-molecule-1, soluble-intercellular-adhesion-molecule-1, total cholesterol, low-densitylipoprotein, interleukin-6, B-type-Natriuretic-Peptide; systolic/diastolic blood pressure were quantified using a random-effects meta-analysis. A total of 26 articles were included in the metaanalysis after screening the titles, abstracts and full texts. The pooled results for a 1°C decrease of ambient temperature showed an increase of 0.31% (95% CI= 0.26 to 0.38) in cardiac biomarkers (p=0.00; I-squared=99.2%; Cochran's Q=5636.8). In contrast, the pooled results for a 1°C increase in ambient temperature showed an increase of 2.03% (95% CI= 1.08 to 3.82) in cardiac biomarkers (p=0.00; I-squared=95.7%; Cochran's Q=235.2). In the cardiovascular (CV) population, the percent increase in cardiac biomarkers levels due to a decrease/increase in ambient temperature was greater. This study showed the decrease/increase in ambient temperature has a direct correlation with the alterations in cardiac biomarkers. These findings are useful for managing temperatureassociated cardiovascular mortality.

Keywords: Meta-analysis; ambient temperature; blood pressure; c-reactive protein; cardiac markers; low-densitylipoprotein..

Fig. (1)

Preferred reporting items for systematic reviews and meta-analysis (PRISMA) flow diagram for the selection of studies.

Fig. (2)

Meta-analysis of alterations in the cardiac markers with a decrease of 1°C in ambient temperature. All estimates were standardized to the percent increase in cardiac markers per 1°C decrease in ambient temperature. Abbreviations: CM, cardiac markers; CRP, C-Reactive Protein; sVCAM, Soluble Cell Adhesion Molecule-1; sIAM, Soluble Intercellular Adhesion Molecule-1; TC, Total cholesterol; LDL, low-density lipoprotein cholesterol; IL-6, Interkleukin-6; BNP, B-type Natriuretic Peptide; SBP, Systolic blood pressure; DBP, diastolic blood pressure; Mea, measurement.

Fig. (3)

Meta-analysis of alterations in the cardiac markers with an increase of 1°C in ambient temperature. All estimates were standardized to the percent increase in cardiac markers per 1°C increase in ambient temperature. Abbreviations: CM, cardiac markers; CRP, C-Reactive Protein; BNP, B-type Natriuretic Peptide; SBP, Systolic blood pressure; DBP, diastolic blood pressure; Mea, measurement.

Fig. (4)

Meta-analysis of alterations in the cardiac markers with a decrease of 1°C in ambient temperature in general (A) and cardiovascular (CV) (B) population. All estimates were standardized to the percent increase in cardiac markers per 1°C decrease in ambient temperature. Abbreviations: CM, cardiac markers; CRP, C-Reactive Protein; sVCAM, Soluble Cell Adhesion Molecule-1; sIAM, Soluble Intercellular Adhesion Molecule-1; TC, Total cholesterol; LDL, low-density lipoprotein cholesterol; IL-6, Interkleukin-6; BNP, B-type Natriuretic Peptide; SBP, Systolic blood pressure; DBP, diastolic blood pressure; Mea, measurement.

Fig. (5)

Meta-analysis of alterations in the cardiac markers with an increase of 1°C in ambient temperature in general (A) and cardiovascular (B) populations. All estimates were standardized to the percent increase in cardiac markers per 1°C decrease or increase in ambient temperature. Abbreviations: CM, cardiac markers; CRP, C-Reactive Protein; BNP, B-type Natriuretic Peptide; SBP, Systolic blood pressure; Mea, measurement.