Evidence demonstrating the link between TC exposure and ACS is limited, particularly in developing countries. A time-stratified case-crossover study published in the European Heart Journal investigated the short-term association between TC exposure and ACS incidence and evaluated potential effect modifiers.

A nationwide registry was searched to include patients with ACS in mainland China between 2015 and 2022. TC-associated wind speeds were estimated using the Willoughby wind field model. TC exposure was defined as the occurrence of daily maximum sustained wind speeds ≥17.5 m/s.

The outcomes of the study were ACS and its subtypes, including non-ST-elevation myocardial infarction, ST-elevation myocardial infarction, and unstable angina. TC–ACS associations and lag structures were assessed using conditional quasi-Poisson models with distributed lag non-linear models. Subgroup analyses were performed to identify potential effect modifiers.

The analysis included 2,563,780 individuals (64.0 ± 12.4 years; 68% were male). Compared with non-TC days, TC days were associated with longer admission-to-catheterization times (1.0 vs 0.9 hours) and longer delays in self-referral to the hospital (5.8 vs 5.3 hours).
Over the 0-3-day period following TC exposure, results showed the risk of developing ACS increased by 14% (95% confidence interval: 2% to 27%) increase in the relative risk of developing ACS. Stronger associations were observed among males, individuals with lower education levels, and those with multiple ACS risk factors.

TC exposure may increase the ACS burden through simultaneous increases in incidence risk and treatment delays. Coordinated action by government agencies, healthcare institutions, and the public may help mitigate TC-associated ACS burden.