{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:43:41Z","timestamp":1788183821520,"version":"build-2803163510"},"reference-count":18,"publisher":"BMJ","issue":"8","funder":[{"name":"Sigrid Juselius Foundation"},{"name":"University of Oulu Strategic Funding"},{"DOI":"10.13039\/501100005878","name":"Terveyden Tutkimuksen Toimikunta","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005878","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Foundation for Cardiovascular Disease"},{"DOI":"10.13039\/501100004756","name":"Emil Aaltosen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004756","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,6,18]]},"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To test the a priori hypothesis that the association between cold spells and ischaemic sudden cardiac death (SCD) is modified by the severity of coronary stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The home coordinates of 2572 autopsy-verified cases of ischaemic SCD aged \u226535 in the Province of Oulu, Finland, were linked to 51 years of weather data. Cold spell was statistically defined for each home address as unusually cold weather pertinent to the location and time of year. We estimated the occurrence of cold spells during the hazard period (7 days preceding death) and reference periods (the same calendar days over 51 years) in a case-crossover setting applying conditional logistic regression, controlling for temporal trends and stratifying by severity of coronary stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The association between cold spells and ischaemic SCD was stronger among patients with 75%\u201395% stenosis (OR 2.03; 95%\u2009CI 1.31 to 3.17), and weaker to non-existent among patients with &lt;75%\u2009stenosis (OR 0.97; 95%\u2009CI 0.37 to 2.55) or coronary total occlusion (100% stenosis) (OR 1.01; 95%\u2009CI 0.52 to 1.96). Lack of calcium-channel blockers and statin therapy seemed to accentuate the role of stenosis during cold spells.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We provide evidence that the association between cold spells and ischaemic SCD is modified by the severity of coronary stenosis. The findings suggest that disturbances in coronary circulation play part in the pathogenesis of SCD during cold weather.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2017-020865","type":"journal-article","created":{"date-parts":[[2018,8,6]],"date-time":"2018-08-06T05:55:35Z","timestamp":1533534935000},"page":"e020865","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Coronary stenosis as a modifier of the effect of cold spells on the risk of sudden cardiac death: a case-crossover study in Finland"],"prefix":"10.1136","volume":"8","author":[{"given":"Niilo R I","family":"Ryti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Juhani","family":"Junttila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harri","family":"Antikainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marja-Leena","family":"Kortelainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heikki V","family":"Huikuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4168-4683","authenticated-orcid":false,"given":"Jouni J K","family":"Jaakkola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,8,5]]},"reference":[{"key":"2024051712015863000_8.8.e020865.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2010.3"},{"key":"2024051712015863000_8.8.e020865.2","doi-asserted-by":"crossref","first-page":"41060","DOI":"10.1038\/srep41060","article-title":"Cold spells and ischaemic sudden cardiac death: effect modification by prior diagnosis of ischaemic heart disease and cardioprotective medication","volume":"7","author":"Ryti","year":"2017","journal-title":"Sci Rep"},{"key":"2024051712015863000_8.8.e020865.3","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.42.8.887"},{"key":"2024051712015863000_8.8.e020865.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-017398","article-title":"Risk of sudden cardiac death in relation to season-specific cold spells: a case-crossover study in Finland","volume":"7","author":"Ryti","year":"2017","journal-title":"BMJ Open"},{"key":"2024051712015863000_8.8.e020865.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.10.065"},{"key":"2024051712015863000_8.8.e020865.6","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpt136"},{"key":"2024051712015863000_8.8.e020865.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.05.086"},{"key":"2024051712015863000_8.8.e020865.8","doi-asserted-by":"crossref","first-page":"FSO30","DOI":"10.4155\/fso.15.28","article-title":"The impact of blood shear rate on arterial thrombus formation","volume":"1","author":"Sakariassen","year":"2015","journal-title":"Future Sci OA"},{"key":"2024051712015863000_8.8.e020865.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.289.6456.1405"},{"key":"2024051712015863000_8.8.e020865.10","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.65.7.1299"},{"key":"2024051712015863000_8.8.e020865.11","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.62.5.925"},{"key":"2024051712015863000_8.8.e020865.12","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1007\/s11739-010-0386-5","article-title":"Coronary spasm provocation with cold pressor test","volume":"5","author":"Ghaffari","year":"2010","journal-title":"Intern Emerg Med"},{"key":"2024051712015863000_8.8.e020865.13","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-66-0098"},{"key":"2024051712015863000_8.8.e020865.14","first-page":"47","article-title":"Coronary artery spasm: current knowledge and residual uncertainties","volume":"10","author":"Slavich","year":"2016","journal-title":"Int J Cardiol Heart Vasc"},{"key":"2024051712015863000_8.8.e020865.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.12.049"},{"key":"2024051712015863000_8.8.e020865.16","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-306276"},{"key":"2024051712015863000_8.8.e020865.17","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.023846"},{"key":"2024051712015863000_8.8.e020865.18","unstructured":"WHO Scientific Group on Sudden Cardiac Death. 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Geneva Switzerland: World Health Organization, 1985."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-020865","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T21:04:10Z","timestamp":1715979850000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-020865"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2018,8,5]]},"published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1136\/bmjopen-2017-020865"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-020865","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8]]}}}