Global warming is claimed to be an important cardiovascular disease risk factor. The air pollution and ambient temperatures are believed to have a significant influence on increased morbidity and premature deaths. To point out possible causative factors for coronary angiography progression in patients presenting with chronic coronary syndrome. There were 66 patients (41 [62%] men and 25 [38%] women) with a median age of 71.5 (62-76) years, who underwent repeated coronary angiographies due to chronic coronary syndrome within a median time interval of 145 (96-296) days. In 18 (27%) patients coronary artery lesion progression was observed despite optimal pharmacotherapy. The demographical, clinical, and personalised epidemiological factors including air pollution particles and ambient temperature exposure were taken into account in the analysis. In the multivariate logistic regression model with backward stepwise elimination method, tropical nights (p = 0.047) and mean daily temperatures (p = 0.043) were revealed as predictors of coronary lesion progression > 30%. The analysis of seasonal temperature changes showed significant differences related to minimal winter temperatures between both groups (p = 0.018). Coronary artery lesion progression can be related to either high values of daily temperatures or to low ambient temperature. The dichotomous characteristics of temperature exposure to atherosclerosis progression suggest a detrimental role of environmental extremities on human health.