Abstract
BACKGROUND: Although cold temperatures have been associated with an increased risk of heart failure (HF) hospitalizations, heterogeneity currently exists when considering a broader range of meteorological variables and exposure periods. OBJECTIVES: The authors assessed HF hospitalization risk conferred by temperature, relative humidity, atmospheric pressure, and rainfall during different exposure timeframes. METHODS: We performed a retrospective analysis of 4,512 patients admitted for acute dyspnea and diagnosed with acute HF at the emergency department (ED) of the Nancy University Hospital (from January 2010 to October 2022) as part of the PARADISE (Pathway of Dyspneic patients in Emergency) study. For the considered variables, mean daily values were used to calculate averages for different timeframes (ie, 3 days, 7 days, 14 days, and 1 month) before emergency department consultation. RESULTS: Multivariable Poisson regression showed an inverse association between temperature and HF hospitalizations across all timeframes (incidence rate ratio [IRR] ∼0.90 per 5 °C increase; all P < 0.001). Increased rainfall over 1 week or 1 month (IRR for 5 mm = 1.11 and 1.18, respectively; both P < 0.035) and elevated atmospheric pressure over 1 month (IRR for 5 hPa = 1.06; P = 0.003) were also associated with an increased risk of subsequent HF hospitalization. Models including temperature significantly outperformed those excluding it. By likelihood ratio test, a stepwise increase in HF risk was observed with prolonged temperature exposure up to 1 week, after which the risk plateaued. CONCLUSIONS: Temperature is independently associated with HF hospitalizations, with the risk increasing up to 1 week of exposure. This timeframe may represent the optimal window for predicting HF-related events.