title: World soccer cup as a trigger of cardiovascular events.
abstract: BACKGROUND
  Acute coronary syndromes are the major cause of death in Brazil and in the world. External stimuli, known also as triggers, such as emotional state and activity, may generate physiopathological changes that can trigger acute coronary syndromes. Among the studied triggers, the impact of stressful events, such as soccer championships, are controversial in literature and there is no effective data on the Brazilian population.
  
  
  OBJECTIVE
  To evaluate the acute effects of environmental stress induced by soccer games of the World Soccer Cup on increased incidence of cardiovascular diseases in Brazil.
  
  
  METHODS
  Public data were obtained from the Unified Health System (Sistema Único de Saúde), regarding hospital admissions that had the International Code Disease of acute coronary syndromes from May to August, in 1998, 2002, 2006 and 2010 (155,992 admissions). Analysis was restricted to patients older than 35 years and admitted by clinical specialties. The incidence of myocardial infarction, angina and mortality were compared among days without World Cup soccer games (Group I: 144,166; 61.7 ± 12.3; 59.4% males); on days when there were no Brazil's soccer team matches (Group II: 9,768; 61.8 ± 12.3; 60.0% males); and days when there were Brazil's soccer team matches (Group III; 2,058; 61.6 ± 12.6; 57.8% males). Logistic regression was used to adjust to age, gender, population density and number of medical assistance units.
  
  
  RESULTS
  The incidence of myocardial infarction increased during the period of World Cup soccer games (1.09; 95%CI = 1.05-1.15) and days when there were Brazil's matches (1.16; 95%CI = 1.06-1.27). There was no impact on mortality during the Cup (1.00; CI 95% = 0.93-1.08) and Brazil's matches (1.04; 95%CI = 0.93-1.22).
  
  
  CONCLUSIONS
  World Cup soccer games and, specially, Brazil's matches have an impact on the incidence of myocardial infarction, but not on in-hospital mortality.
authors: Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Brazil.
authors: Daniel Guilherme Suzuki
authors: DG
authors: Borges
authors: Rosane Aparecida
authors: RA
authors: Monteiro
authors: André
authors: A
authors: Schmidt
authors: Antonio
authors: A
authors: Pazin-Filho
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology / Q000209:etiology; D000368:Aged; D000704:Analysis of Variance; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D015985:Precipitating Factors; D012307:Risk Factors; D017678:Sex Distribution; D012916:Soccer / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications; D013997:Time Factors