Football spectatorship and selected acute cardiovascular events: lack of a population-scale association in Poland

BACKGROUND The status of football spectatorship-induced emotional stress as a risk factor for acute cardiovascular (CV) events remains in dispute. Aims: To examine the relation between football spectatorship and the incidence of selected acute CV events across the Polish male population. METHODS Events occurring in male patients aged 35 and older across Poland during three tournaments (the 2012 and 2016 European Championships - EC and the 2018 World Cup - WC) were retrospectively analysed through hospital admission codes obtained from the National Health Fund. Of interest were the following primary diagnoses: acute myocardial infarction (AMI, I21), sudden cardiac arrest (SCA, I46), sudden arrhythmias (SA, I47 - I49). The same dates in the years before and after the tournaments constituted the reference periods. RESULTS A total of 255,383 patients were included in this study. There were no significant differences in the incidence of events between the combined exposure and reference periods: RR = 1.05 (95% CI 0.97 to 1.14, P = 0.20) for AMI, RR = 1.08 (95% CI 0.87 to 1.35, P = 0.47) for SCA, and RR = 1.02 (95% CI 0.98 to 1.06, P = 0.32) for SA. Individual tournament analyses revealed a higher incidence of AMI (RR = 1.20, 95% CI 1.12 - 1.30, P < 0.001) during WC. However, day-by-day analysis of WC did not find a higher incidence of AMI on match vs. match-free days. CONCLUSIONS The emotional stress evoked by football spectatorship is insufficiently potent to precipitate a population-scale increase in selected acute CV events.