Cardiovascular Events During World Cup Soccer, an Old Article Worth Remembering

Is it possible for a soccer match to trigger an infarction? Is it possible for the stress derived from watching our national team play to trigger a cardiovascular event? Many might think that these are exaggerations. However, not only is it possible, but it has been proved beyond the shadow of a doubt for some time now. And the ideal time to answer these questions definitively is during a FIFA World Cup.

We often use these sections to comment on the latest articles published, but the soccer World Cup never goes unnoticed (particularly in Latin America). That is the reason why we bring back this article published in NEJM almost 10 years ago.

The 2006 FIFA World Cup Germany provided an opportunity to examine the relation between emotional stress and the incidence of cardiovascular events. Cardiovascular events in Munich during the World Cup were prospectively assessed alongside events that occurred in the same months of different years (as control periods).

During the World Cup, there were 4279 acute cardiovascular events, many more than during control periods.

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On days of matches involving the German team, the incidence of cardiac emergencies almost tripled the incidence during the control period (2.66 times more; 2.33 to 3.04; p = 0.0001). However, if we take into account men only, the incidence was more than three-fold (3.26 times; p < 0.001). Women were able to enjoy the games a little calmer, although their risk of events almost doubled the risk observed during the control period (1.82 times).

The proportion of patients with known coronary heart disease was 47%, as compared with 29.1% of patients with events during the control period.

The highest incidence of events was observed during the 2 hours after the beginning of each match involving the German team.

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The incidence of myocardial infarction with ST-segment elevation during the World Cup increased 2.49 times, of myocardial infarction without ST-segment elevation or unstable angina increased 2.61 times, and of life-threatening arrhythmia increased 3.07 times compared with the control period (p < 0.0001 for all comparisons).

We should take into account that this study was carried out in a population often considered less “hot-tempered” than the overall Latin American population. What was the incidence of infarction in Brazil in 2014 during the semifinal match? And what about in Argentina, in 2018, upon seeing their best player miss a penalty? We probably will never have the exact figures, but we can be certain that there were many more events than in any other time point.

Conclusion

Viewing a stressful soccer match during the World Cup at least doubles the risk of a cardiovascular event. In view of these results, preventive measures should be taken, particularly for men with known coronary heart disease.

Original title: Cardiovascular Events During World Cup Soccer.

Reference: Ute Wilbert-Lampen et al. N Engl J Med 2008;358:475-83.