Wilbert-Lampen Ute, Leistner David, Greven Sonja, Pohl Tilmann, Sper Sebastian, Völker Christoph, Güthlin Denise, Plasse Andrea, Knez Andreas, Küchenhoff Helmut, Steinbeck Gerhard
Medizinische Klinik und Poliklinik I, Campus Grosshadern, Germany.
N Engl J Med. 2008 Jan 31;358(5):475-83. doi: 10.1056/NEJMoa0707427.
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.
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.
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).
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.
2006年6月9日至7月9日在德国举行的国际足联世界杯提供了一个检验情绪应激与心血管事件发生率之间关系的机会。
世界杯期间，大慕尼黑地区患者发生的心血管事件由急诊医生进行前瞻性评估。我们将这些事件与对照期（2006年5月1日至6月8日、7月10日至7月31日以及2003年和2005年5月1日至7月31日）发生的事件进行比较。
对4279例患者的急性心血管事件进行了评估。在德国队参赛的比赛日，心脏急症的发生率是对照期的2.66倍（95%置信区间[CI]，2.33至3.04；P<0.001）；男性的发生率是对照期的3.26倍（95%CI，2.78至3.84；P<0.001），女性的发生率是对照期的1.82倍（95%CI，1.44至2.31；P<0.001）。在德国队比赛日发生冠状动脉事件的患者中，已知患有冠心病的患者比例为47.0%，而对照期事件患者的这一比例为29.1%。在这些日子里，每场比赛开始后的前2小时内事件的平均发生率最高。与对照期相比，对该时期严重事件的亚分析显示，ST段抬高型心肌梗死的发生率增加了2.49倍（95%CI，1.47至4.23），非ST段抬高型心肌梗死或不稳定型心绞痛的发生率增加了2.61倍（95%CI，2.22至3.08），引起严重症状的心律失常的发生率增加了3.07倍（95%CI，2.32至4.06）（所有比较P<0.001）。
观看一场紧张的足球比赛会使急性心血管事件的风险增加一倍多。鉴于这种额外风险，尤其是在已知患有冠心病的男性中，迫切需要采取预防措施。
