Background

Environmental stress affecting a large number of people can be induced by catastrophes such as earthquakes, and hurricanes as well as terror or war, but also by large sporting events and is associated with cardiovascular diseases and their acute manifestations like myocardial infarction (MI). Nevertheless, the association between important soccer events and acute cardiovascular illnesses remains controversial. Although a few studies support the hypothesis that large sporting events may induce higher rates of cardiovascular events as well as higher short-term mortality, other studies failed to confirm these findings.

The German national soccer team is one of the best teams in the world winning the Fédération Internationale de Football Association (FIFA) world championship four times, last in the year 2014, and finishing in the third place in 2006 and 2010. Overall, more than 34.5 million people watched the German victory on television at the FIFA world soccer cup in Brazil 2014.  

Thus, as approximately half of the German citizens occupied itself with the big sporting event, we aimed to investigate I) the impact of the FIFA world cup 2014 on total numbers and in-hospital mortality of patients with MI in Germany and II) whether the soccer games of the German national team influenced the number of admissions and in-hospital mortality during the FIFA world cup 2014.

Methods

We analyzed data of MI patients of the German nationwide inpatient sample (2014-2015). Patients admitted due to MI during soccer world cup 2014 (12^th June to 13^th July 2014) were compared to those during the comparison-period 2015 (12^th June to 13^th July 2015) without soccer world cup (source: RDC of the Federal Statistical Office and the Statistical Offices of the federal states, DRG Statistics 2014-2015, and own calculations).

Results

Overall, the total number of MI patients was higher during the FIFA world cup 2014 than in the comparison-period 2015 (18,479 vs. 17,794, 3.7% more patients). Patient characteristics did not differ between both groups. In contrast, drug eluting stent implantations were more often performed during the comparison-period 2015 than during world cup 2014 (50.0% vs. 44.5%, P<0.001), whereas rate of percutaneous coronary intervention (P=0.144) was balanced. In-hospital mortality rate was comparable between both periods (8.3% vs. 8.4%, P=0.892).

During the world cup 2014, in-hospital mortality rate was not affected by the games of the German national team (8.9% vs. 8.1%, P=0.110). However, we observed an increase of the in-hospital mortality rate from 7.9%-9.3% before to 12.0% at the final. Nevertheless, neither significant increase of total numbers (β -0.006 (95%CI -0.026 to 0.015), P=0.502) nor of in-hospital death (β -0.0003 (95%CI -0.0009 to 0.0004), P=0.416) during the German games throughout the world cup could be detected.

Conclusions

Number of admissions due to MI in Germany was 3.7% higher during the 2014 FIFA soccer world cup in comparison to the comparison-period 2015. While in-hospital mortality of MI was not affected by the soccer world cup, the in-hospital mortality was highest at the world cup final.