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BMJ 2008; 336 doi: (Published 07 February 2008) Cite this as: BMJ 2008;336:300

Football world cup linked to sharp rise in cardiac emergencies

The incidence of cardiac emergencies around Munich in Germany more than doubled during the 2006 football world cup, a study has found. On the days when the Germany team was playing, 2.66 times more cardiac emergencies (95% CI 2.33 to 3.04), 2.49 (1.47 to 4.23) times more heart attacks with ST elevation, and 3.07 (2.32 to 4.06) times more serious arrhythmias occurred in the area than had occurred during control periods before and after the competition. Germany played seven matches during the 2006 world cup. Six of them were associated with an increase in cardiac emergencies. The quarter final match against Argentina, which Germany won after a penalty shoot out, and the semi-final match against Italy, which the home team lost, seem to have been the most stressful. Germany eventually came third after beating Portugal in a match that had no discernible effect on cardiac events.

The link between football and cardiac emergencies was stronger for men than for women, although it was significant for both. It was strongest for people with known heart disease. The first two hours after the start of a match was the riskiest period, so the authors suspect that the emotional stress of watching crucial games triggered many of the extra events. Their analysis included only Germans, so the incidence wasn’t inflated by the influx of excitable foreign fans.

Still no conclusive evidence favouring one drug eluting stent over another

Paclitaxel eluting stents and sirolimus eluting stents both reduce the risk of serious cardiac events in eligible patients with ischaemic heart disease. It is proving harder than expected to find out which one works best, however. The latest and largest trial to date reported no difference between the two, but the authors and an editorial agree that it isn’t the final word (p 454). The participants had …

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