Abstract 10682: Is Acute Heart Failure Admission Linked to a Change in Temperature? Insights from ASCEND-HF
INTRODUCTIONS: Weather has been suggested as a factor that precipitates an acute heart failure (AHF) episode but prior observations are limited by regional data and use of monthly temperatures. We sought to identify a vulnerable population susceptible to changes in weather conditions, and the relationship between weather and time intervals prior to an AHF episode.
METHODS: ASCEND-HF enrolled 7007 pts with AHF between 2007 and 2010 (397 sites, 30 countries). A Google interface identified the weather stations reporting data to the National Climatic Data Center nearest to each site. Each station provides 4 daily measurements for each variable (temperature (TEMP), relative humidity, barometric pressure, wind speed, and precipitation). A TEMP change was defined as occurring <10% of the time against the local 30d TEMP history (to control for local seasonality and region).(FIGURE) “Vulnerable pts” were those with older age, increased Charlson index, a low EF and ischemic etiology.
RESULTS: The mean age of pts was 65yrs (SD 14.2), 66% were male, 83% had EF<40%, and 60% had an ischemic etiology. Overall, there was no association globally between TEMP or other climate variables and HF presentation or comorbidity burden. In the analysis of “vulnerable pts” we observed that an AHF episode following a TEMP rise in the 48hrs preceding their randomization was more likely (aOR= 1.22; 95%CI 1.00-1.49) for those with a low EF. In the more distant time intervals, ischemic pts were more sensitive to temperature increases in the 3-7d prior to randomization (aOR = 1.13; 95%CI 1.00-1.28), whereas the non-ischemic pts were more sensitive to a drop in TEMP in the 3 distant time periods (aOR = 1.12; 95%CI 0.99-1.25).
CONCLUSION: Weather events did not herald AHF events in the overall ASCEND-HF population using daily pt-normalized meteorological data. However, pts with a low EF and those with an ischemic etiology were susceptible to changes in TEMP, independent of comorbidity burden.
- © 2011 by American Heart Association, Inc.