"We have recently demonstrated a 2.7-fold increase in the incidence of acute cardiovascular events in association with World Cup soccer matches," lead author Dr. Ute Wilbert-Lampen told Reuters Health by email. "Because of the close time relationship, it seems likely that these additional cardiac emergencies were triggered by emotional stress."

To gain insight on the underlying pathophysiology, Dr. Wilbert-Lampen and colleagues at Ludwig-Maximilians University in Munich studied 58 patients who had acute coronary syndromes (ACS) during World Cup matches, 58 patients with non-stress related ACS (the reference group), and 58 healthy volunteers.

In a February 16th paper in the Journal of the American College of Cardiology, the researchers report that compared to the referent group, World Cup patients had significantly higher levels of several inflammatory mediators, including soluble CD40L, soluble vascular cell adhesion molecule-1, monocyte chemoattractant protein-1, and tumor necrosis factor-alpha. These mediators, in turn, were positively linked to levels of endothelin-1.

Both endothelin-1 and monocyte chemoattractant protein-1 performed very well in discriminating stress ACS from non-stress ACS.

The results suggest that drugs targeting endothelin-1 may be useful in combating stress-mediated cardiovascular morbidity, Dr. Wilbert-Lampen said.