title: Cardiovascular events during World Cup soccer.
abstract: BACKGROUND
  The Fédération Internationale de Football Association (FIFA) World Cup, held in Germany from June 9 to July 9, 2006, provided an opportunity to examine the relation between emotional stress and the incidence of cardiovascular events.
  
  
  METHODS
  Cardiovascular events occurring in patients in the greater Munich area were prospectively assessed by emergency physicians during the World Cup. We compared those events with events that occurred during the control period: May 1 to June 8 and July 10 to July 31, 2006, and May 1 to July 31 in 2003 and 2005.
  
  
  RESULTS
  Acute cardiovascular events were assessed in 4279 patients. On days of matches involving the German team, the incidence of cardiac emergencies was 2.66 times that during the control period (95% confidence interval [CI], 2.33 to 3.04; P<0.001); for men, the incidence was 3.26 times that during the control period (95% CI, 2.78 to 3.84; P<0.001), and for women, it was 1.82 times that during the control period (95% CI, 1.44 to 2.31; P<0.001). Among patients with coronary events on days when the German team played, the proportion with known coronary heart disease was 47.0%, as compared with 29.1% of patients with events during the control period. On those days, the highest average incidence of events was observed during the first 2 hours after the beginning of each match. A subanalysis of serious events during that period, as compared with the control period, showed an increase in the incidence of myocardial infarction with ST-segment elevation by a factor of 2.49 (95% CI, 1.47 to 4.23), of myocardial infarction without ST-segment elevation or unstable angina by a factor of 2.61 (95% CI, 2.22 to 3.08), and of cardiac arrhythmia causing major symptoms by a factor of 3.07 (95% CI, 2.32 to 4.06) (P<0.001 for all comparisons).
  
  
  CONCLUSIONS
  Viewing a stressful soccer match more than doubles the risk of an acute cardiovascular event. In view of this excess risk, particularly in men with known coronary heart disease, preventive measures are urgently needed.
authors.affiliation: Medizinische Klinik und Poliklinik I, Campus Grosshadern, Germany. lampen@med.uni-muenchen.de
authors.forename: Ute
authors.initials: U
authors.lastname: Wilbert-Lampen
authors.forename: David
authors.initials: D
authors.lastname: Leistner
authors.forename: Sonja
authors.initials: S
authors.lastname: Greven
authors.forename: Tilmann
authors.initials: T
authors.lastname: Pohl
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sper
authors.forename: Christoph
authors.initials: C
authors.lastname: Völker
authors.forename: Denise
authors.initials: D
authors.lastname: Güthlin
authors.forename: Andrea
authors.initials: A
authors.lastname: Plasse
authors.forename: Andreas
authors.initials: A
authors.lastname: Knez
authors.forename: Helmut
authors.initials: H
authors.lastname: Küchenhoff
authors.forename: Gerhard
authors.initials: G
authors.lastname: Steinbeck
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000368:Aged; D000789:Angina, Unstable / Q000453:epidemiology; D001145:Arrhythmias, Cardiac / Q000453:epidemiology*; D003327:Coronary Disease / Q000150:complications; D005260:Female; D005858:Germany; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D016012:Poisson Distribution; D011446:Prospective Studies; D012044:Regression Analysis; D012916:Soccer / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications*