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Cardiovascular impact of modern warfare: STEMI patterns before and during the Israel-Hamas conflict

Hussein Sliman1,2, Rim Kasem Ali Sliman3,4, Amir Aker1,2

  • 1Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, 7 Michal Street, Haifa, 34632, Israel.

Scientific Reports
|July 18, 2026
PubMed

Insights

Acute conflict-related stress did not significantly increase ST-elevation myocardial infarction (STEMI) incidence, despite ongoing conflict. Long-term trends show a gradual rise in STEMI, with no immediate surge observed during the recent Israel-Hamas conflict.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Emotional stress in conflict zones is a potential risk factor for cardiovascular events.
  • Acute coronary syndrome (ACS) incidence may be affected by acute stress.
  • The impact of the Israel-Hamas conflict on cardiovascular health, specifically ST-elevation myocardial infarction (STEMI), requires investigation.

Purpose of the Study:

  • To assess the impact of the Israel-Hamas conflict on STEMI incidence.
  • To compare STEMI admissions during the conflict period with previous years.
  • To analyze trends in STEMI and sudden cardiac death (SCD) in relation to the conflict.

Main Methods:

  • Retrospective study using Clalit Israeli data center records.
  • Multi-level analysis of STEMI incidence: conflict vs. pre-conflict year, outbreak day/week, decade-long trends (2013-2024), and geographic distribution.
  • Analysis of sudden cardiac death (SCD) patterns and post-STEMI left ventricular ejection fraction (LVEF).

Main Results:

  • STEMI incidence showed a non-significant increase during the conflict period (526.03 to 539.62 per 100,000).
  • No significant STEMI increase was observed on the outbreak day or during the subsequent week compared to 2022.
  • A gradual decade-long increase in STEMI was noted, with improved LVEF post-STEMI, despite a non-significant rise in mortality.

Conclusions:

  • Acute conflict-related stress did not significantly impact STEMI incidence beyond established progressive trends.
  • Findings suggest potential population-level attenuation of acute cardiovascular stress responses during the conflict.
  • Further research with larger sample sizes and care-quality metrics is warranted due to potential confounders and limited statistical power.

Keywords:
Acute coronary syndrome (ACS)Armed conflictCardiovascular healthCardiovascular stressorsClalit Israeli data centerPsychosocial stressST-elevation myocardial infarction (STEMI)Sudden cardiac death (SCD)War-related health impacts

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