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 events remains a matter of dispute. Aims: This study aimed to investigate the relationship between football spectatorship and the incidenceof selected acute cardiovascular events in the Polish male population. METHODS: Events that occurred in male patients aged 35 years and older in Poland during 3 tournaments(2012 and 2016 European Championships and 2018 World Cup) were retrospectively analyzed based onhospital admission codes (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD‑10]) obtained from the Polish National Health Fund (Narodowy Fundusz Zdrowia). The followingprimary diagnoses were of interest: acute myocardial infarction (AMI; I21), sudden cardiac arrest (I46),sudden arrhythmias (I47-I49). The corresponding dates in the years before and after the tournamentsconstituted 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: relative risk [RR] = 1.05 (95% CI, 0.97-1.14; P = 0.2) for AMI, RR = 1.08 (95% CI, 0.87-1.35;P = 0.47) for sudden cardiac arrest, and RR = 1.02 (95% CI, 0.98-1.06; P = 0.32) for sudden arrhythmias. Individual tournament analyses revealeda higher incidence of AMI (RR = 1.2; 95% CI, 1.12-1.3; P <0.001) during the World Cup. However, day ‑by ‑‑day analysis for the World Cup did not show a higher incidence of AMI on match versus match‑free days. CONCLUSIONS: Emotional stress evoked by football spectatorship is insufficiently potent to precipitatea population‑scale increase in the incidence of selected acute cardiovascular events.