Extent of Myocardial Damage in Patients after Emotional Stress-Induced Myocardial Infarction during Euro Cup Soccer 2008

Background: The World Cup soccer 2006 has been shown to provoke levels of stress sufficient to increase the incidence of acute coronary syndrome. However, the clinical outcome of these patients remains elusive. We sought to assess whether emotional stress-induced myocardial infarction might increase myocardial damage compared to non-stress-induced events. Design and Methods: We prospectively analysed the extent of left ventricular damage after emotional stress-induced myocardial infarction occurred during Euro Cup Soccer 2008 (study group, n = 51). Data were compared to a matched reference group (n = 55). The primary endpoint was a composite of cardiac troponin-T/I and the left ventricular ejection fraction at day 4th after the initial event. Results: Compared to standard values of troponin T and troponin I, concentrations were increased in both the study group and the reference group (troponin T: 4.7 ± 8.5 ng/ml vs. 2.4 ± 4.3 ng/ml; troponin I: 13.1 ± 16.5 ng/ml vs. 8.7 ± 13.9 ng/ml). The difference, adjusted for confounding variables, between both groups did not reach statistical significance (p = 0.33). Likewise, left ventricular ejection fraction (EF) was decreased in both the study patients and the reference group (51% ± 12% EF vs. 55% ± 10% EF), the difference between both groups was just not significant (p = 0.12). Discussion: In conclusion, because of the lack of significance, we cannot testify at present, weather emotional stress, e.g. induced by soccer matches of the national team, influences the extent of myocardial damage following myocardial infarction. However, a positive correlation can be assumed, because the troponin levels are considerably higher in the study group than in the control group.