Advertisement
Canadian Journal of Cardiology

Hockey Games and the Incidence of ST-Elevation Myocardial Infarction

Published:March 28, 2018DOI:https://doi.org/10.1016/j.cjca.2017.12.028

      Abstract

      Background

      The association between diagnosed acute ST-elevation myocardial infarction (STEMI) and hockey games in the Canadian population is unknown.

      Methods

      We retrospectively analyzed the association between hockey games of the National Hockey League Montreal Canadiens and daily hospital admissions for acute STEMI at the Montreal Heart Institute, Canada.

      Results

      Between June 2010 and December 2014, a total of 2199 patients (25.9% women; mean age, 62.6 ± 12.4 years) were admitted for acute STEMI. An increase in STEMI admissions was observed the day after a hockey game of the Montreal Canadiens in the overall population (from 1.3 ± 1.2 to 1.5 ± 1.3), however, this difference was not significant (P = 0.1). The number of STEMI admissions increased significantly from 0.9 ± 1.0 to 1.2 ± 1.0 per day in men (P = 0.04), but not in women (P = 0.7). The association between ice hockey matches and STEMI admission rates was strongest after a victory of the Montreal Canadiens. Accordingly, an increased risk for the occurrence of STEMI was observed in the overall population (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.0-1.3; P = 0.037) when the Montreal Canadiens won a match. This association was present in men (HR, 1.2; 95% CI, 1.03-1.4; P = 0.02) but not in women (P = 0.87), with a most pronounced effect seen in younger men (younger than 55 years; HR, 1.4; 95% CI, 1.1-1.8; P = 0.009).

      Conclusions

      Although a weak association between hockey games and hospital admissions for STEMI was found in our overall population, the event of a hockey game significantly increased the risk for STEMI in younger men. Preventive measures targeting behavioural changes could positively affect this risk.

      Résumé

      Introduction

      On ignore l’association entre le diagnostic d’infarctus du myocarde (IM) aigu avec élévation du segment ST et les matchs de hockey chez la population canadienne.

      Méthodes

      Nous avons analysé de manière rétrospective l’association entre les matchs de hockey des Canadiens de Montréal de la Ligue nationale de hockey et les admissions quotidiennes en raison d’un IM aigu avec élévation du segment ST à l’Institut de cardiologie de Montréal, au Canada.

      Résultats

      Entre juin 2010 et décembre 2014, un total de 2199 patients (25,9 % de femmes ; âge moyen, 62,6 ± 12,4 ans) étaient admis en raison d'un IM aigu avec élévation du segment ST. Nous avons observé une augmentation des admissions en raison d’un IM avec élévation du segment ST après un match de hockey des Canadiens de Montréal dans la population globale (de 1,3 ± 1,2 à 1,5 ± 1,3). Toutefois, cette différence n’était pas significative (P = 0,1). Le nombre d’admissions en raison d’un IM avec élévation du segment ST augmentait de manière significative de 0,9 ± 1,0 à 1,2 ± 1,0 par jour chez les hommes (P = 0,04), mais non chez les femmes (P = 0,7). L’association entre les matchs de hockey sur glace et les taux d’admission en raison d’un IM avec élévation du segment ST était plus forte après une victoire des Canadiens de Montréal. Par conséquent, nous avons observé un risque accru de survenue d’un IM avec élévation du segment ST dans la population globale (rapport de risque [RR], 1,15 ; intervalle de confiance [IC] à 95 %, 1,0-1,3 ; P = 0,037) lorsque les Canadiens de Montréal gagnent le match. Cette association était présente chez les hommes (RR, 1,2 ; IC à 95 %, 1,03-1,4 ; P = 0,02), mais non chez les femmes (P = 0,87), et montrait un effet plus marqué chez les hommes plus jeunes (de moins de 55 ans ; RR, 1,4 ; IC à 95 %, 1,1-1,8 ; P = 0,009).

      Conclusions

      Bien que nous ayons observé une faible association entre les matchs de hockey et les admissions à l’hôpital en raison d’un IM avec élévation du segment ST dans notre population globale, le fait de regarder un match de hockey augmentait de manière significative le risque d’IM avec élévation du segment ST chez les hommes plus jeunes. Des mesures de prévention qui visent les changements de comportement pourraient influencer de manière positive le risque.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Canadian Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Benjamin E.J.
        • Blaha M.J.
        • Chiuve S.E.
        • et al.
        Heart disease and stroke statistics-2017 update: a report from the American Heart Association.
        Circulation. 2017; 135: e146-603
        • Olsen P.
        • Elliott J.M.
        • Frampton C.
        • Bradley P.S.
        Winning or losing does matter: acute cardiac admissions in New Zealand during Rugby World Cup tournaments.
        Eur J Prev Cardiol. 2015; 22: 1254-1260
        • Wilbert-Lampen U.
        • Leistner D.
        • Greven S.
        • et al.
        Cardiovascular events during World Cup soccer.
        N Engl J Med. 2008; 358: 475-483
        • Witte D.R.
        • Bots M.L.
        • Hoes A.W.
        • Grobbee D.E.
        Cardiovascular mortality in Dutch men during 1996 European football championship: longitudinal population study.
        BMJ. 2000; 321: 1552-1554
        • Kloner R.A.
        • McDonald S.
        • Leeka J.
        • Poole W.K.
        Comparison of total and cardiovascular death rates in the same city during a losing versus winning super bowl championship.
        Am J Cardiol. 2009; 103: 1647-1650
        • Toubiana L.
        • Hanslik T.
        • Letrilliart L.
        French cardiovascular mortality did not increase during 1996 European football championship.
        BMJ. 2001; 322: 1306
        • Barone-Adesi F.
        • Vizzini L.
        • Merletti F.
        • Richiardi L.
        It is just a game: lack of association between watching football matches and the risk of acute cardiovascular events.
        Int J Epidemiol. 2010; 39: 1006-1013
        • Bauman A.E.
        • van der Ploeg H.P.
        • Chey T.
        • Sholler G.
        The hazards of watching football–are Australians at risk?.
        Med J Aust. 2006; 185: 684-686
        • Niederseer D.
        • Thaler C.W.
        • Egger A.
        • et al.
        Watching soccer is not associated with an increase in cardiac events.
        Int J Cardiol. 2013; 170: 189-194
        • Brunekreef B.
        • Hoek G.
        No association between major football games and cardiovascular mortality.
        Epidemiology. 2002; 13: 491-492
        • Hamilton R.C.
        The medical hazards of television sports.
        CMAJ. 1995; 152: 14-15
        • Khairy L.T.
        • Barin R.
        • Demoniere F.
        • et al.
        Heart rate response in spectators of the Montreal Canadiens hockey team.
        Can J Cardiol. 2017; 33: 1633-1638
        • Thygesen K.
        • Alpert J.S.
        • White H.D.
        Universal definition of myocardial infarction.
        Eur Heart J. 2007; 28: 2525-2538
        • Yip H.K.
        • Chen M.C.
        • Chang H.W.
        • et al.
        Angiographic morphologic features of infarct-related arteries and timely reperfusion in acute myocardial infarction: predictors of slow-flow and no-reflow phenomenon.
        Chest. 2002; 122: 1322-1332
        • NHL.com
        Statistics.
        (Available at:) (Accessed August 1, 2017)
        • Bobb J.F.
        • Ho K.K.
        • Yeh R.W.
        • et al.
        Time-course of cause-specific hospital admissions during snowstorms: an analysis of electronic medical records from major hospitals in Boston, Massachusetts.
        Am J Epidemiol. 2017; 185: 283-294
        • Regitz-Zagrosek V.
        • Oertelt-Prigione S.
        • Prescott E.
        • et al.
        Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes.
        Eur Heart J. 2016; 37: 24-34
        • Vaccarino V.
        • Wilmot K.
        • Al Mheid I.
        • et al.
        Sex differences in mental stress-induced myocardial ischemia in patients with coronary heart disease.
        J Am Heart Assoc. 2016; 5: e003630
        • Culic V.
        Football matches and acute cardiac events: potential effects of a complex psychosocial phenomenon on cardiovascular health.
        Int J Epidemiol. 2011; 40 ([author reply: 1425-6]): 1422-1425
        • Berthier F.
        • Boulay F.
        Lower myocardial infarction mortality in French men the day France won the 1998 World Cup of football.
        Heart. 2003; 89: 555-556
        • Carroll D.
        • Ebrahim S.
        • Tilling K.
        • Macleod J.
        • Smith G.D.
        Admissions for myocardial infarction and World Cup football: database survey.
        BMJ. 2002; 325: 1439-1442
        • Kirkup W.
        • Merrick D.W.
        A matter of life and death: population mortality and football results.
        J Epidemiol Community Health. 2003; 57: 429-432
        • Katz E.
        • Metzger J.T.
        • Schlaepfer J.
        • et al.
        Increase of out-of-hospital cardiac arrests in the male population of the French speaking provinces of Switzerland during the 1998 FIFA World Cup.
        Heart. 2005; 91: 1096-1097
        • Culic V.
        • Eterovic D.
        • Miric D.
        Meta-analysis of possible external triggers of acute myocardial infarction.
        Int J Cardiol. 2005; 99: 1-8
        • Brunner S.
        • Herbel R.
        • Drobesch C.
        • et al.
        Alcohol consumption, sinus tachycardia, and cardiac arrhythmias at the Munich Octoberfest: results from the Munich Beer Related Electrocardiogram Workup Study (MunichBREW).
        Eur Heart J. 2017; 38: 2100-2106
        • Andersson C.
        • Vasan R.S.
        Epidemiology of cardiovascular disease in young individuals.
        Nat Rev Cardiol. 2018; 15: 230-240
        • Ghadri J.R.
        • Sarcon A.
        • Diekmann J.
        • et al.
        Happy heart syndrome: role of positive emotional stress in takotsubo syndrome.
        Eur Heart J. 2016; 37: 2823-2829
        • Qin D.
        • Patel S.M.
        • Champion H.C.
        “Happiness” and stress cardiomyopathy (apical ballooning syndrome/takotsubo syndrome).
        Int J Cardiol. 2014; 172: e182-e183
        • Prasad A.
        • Lerman A.
        • Rihal C.S.
        Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction.
        Am Heart J. 2008; 155: 408-417
        • Tofler G.H.
        • Muller J.E.
        Triggering of acute cardiovascular disease and potential preventive strategies.
        Circulation. 2006; 114: 1863-1872
        • Piira O.P.
        • Mustonen P.E.
        • Miettinen J.A.
        • Huikuri H.V.
        • Tulppo M.P.
        Leisure time emotional excitement increases endothelin-1 and interleukin-6 in cardiac patients.
        Scand Cardiovasc J. 2012; 46: 7-15
        • Piira O.P.
        • Miettinen J.A.
        • Hautala A.J.
        • Huikuri H.V.
        • Tulppo M.P.
        Physiological responses to emotional excitement in healthy subjects and patients with coronary artery disease.
        Auton Neurosci. 2013; 177: 280-285
        • Wilbert-Lampen U.
        • Nickel T.
        • Leistner D.
        • et al.
        Modified serum profiles of inflammatory and vasoconstrictive factors in patients with emotional stress-induced acute coronary syndrome during World Cup Soccer 2006.
        J Am Coll Cardiol. 2010; 55: 637-642
        • Katz E.
        • Metzger J.T.
        • Marazzi A.
        • Kappenberger L.
        Increase of sudden cardiac deaths in Switzerland during the 2002 FIFA World Cup.
        Int J Cardiol. 2006; 107: 132-133