The association between ST-segment depressions and sudden cardiac deaths and arrests after acute coronary syndrome

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology Pub Date : 2025-11-01 Epub Date: 2025-10-11 DOI:10.1016/j.jelectrocard.2025.154145

Konsta Kivimäki , Hanna Pohjantähti , Jussi Hernesniemi , Leo-Pekka Lyytikäinen , Juho Tynkkynen , Jani Rankinen

{"title":"The association between ST-segment depressions and sudden cardiac deaths and arrests after acute coronary syndrome","authors":"Konsta Kivimäki , Hanna Pohjantähti , Jussi Hernesniemi , Leo-Pekka Lyytikäinen , Juho Tynkkynen , Jani Rankinen","doi":"10.1016/j.jelectrocard.2025.154145","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims of the study</h3><div>ST-segment depression in the electrocardiogram (ECG) of acute coronary syndrome (ACS) patients has been associated with higher mortality. But still, its association to sudden cardiac deaths (SCDs) or sudden cardiac arrests (SCAs) has not yet been investigated. We analyzed the association between ST-segment depression in the ECG after angiography and the long-term incidence of SCD and SCA among ACS patients.</div></div><div><h3>Methods</h3><div>Retrospective data of 8565 consecutive ACS patients with a median follow-up time of 7.1 years were analyzed retrospectively. Patients with (<em>n</em> = 1957) and without (<em>n</em> = 6608) ST-segment depression in ECG after angiography were compared after stratification according to the location of ST-segment depression. Incidents of SCDs and SCAs were adjudicated using various sources detailing the circumstances leading to the events. Subdistribution regression (Fine-Gray) models were used in the association analyses.</div></div><div><h3>Results</h3><div>Lateral, inferior, and inferolateral ST-segment depression were associated with the long-term risk for SCD and SCA in age- and sex-adjusted analyses (<em>p</em>-value <0.05). However, only lateral ST-segment depression was associated with a higher risk for SCD (HR 1.58, 95 % CI 1.13–2.20, <em>p</em>-value 0.007) and SCA (HR 1.48, 95 % CI 1.12–1.96, p-value 0.006) when additionally adjusted with several cardiovascular risk factors. The results remained significant in lateral and inferolateral ST-segment depression even after excluding patients with LVEF ≤35 % at baseline.</div></div><div><h3>Conclusion</h3><div>Lateral, inferolateral, and inferior ST-segment depressions in ECG after angiography in ACS patients are associated with a significantly higher long-term risk for SCD and SCA.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154145"},"PeriodicalIF":1.5000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of electrocardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022073625002730","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/10/11 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Aims of the study

ST-segment depression in the electrocardiogram (ECG) of acute coronary syndrome (ACS) patients has been associated with higher mortality. But still, its association to sudden cardiac deaths (SCDs) or sudden cardiac arrests (SCAs) has not yet been investigated. We analyzed the association between ST-segment depression in the ECG after angiography and the long-term incidence of SCD and SCA among ACS patients.

Methods

Retrospective data of 8565 consecutive ACS patients with a median follow-up time of 7.1 years were analyzed retrospectively. Patients with (n = 1957) and without (n = 6608) ST-segment depression in ECG after angiography were compared after stratification according to the location of ST-segment depression. Incidents of SCDs and SCAs were adjudicated using various sources detailing the circumstances leading to the events. Subdistribution regression (Fine-Gray) models were used in the association analyses.

Results

Lateral, inferior, and inferolateral ST-segment depression were associated with the long-term risk for SCD and SCA in age- and sex-adjusted analyses (p-value <0.05). However, only lateral ST-segment depression was associated with a higher risk for SCD (HR 1.58, 95 % CI 1.13–2.20, p-value 0.007) and SCA (HR 1.48, 95 % CI 1.12–1.96, p-value 0.006) when additionally adjusted with several cardiovascular risk factors. The results remained significant in lateral and inferolateral ST-segment depression even after excluding patients with LVEF ≤35 % at baseline.

Conclusion

Lateral, inferolateral, and inferior ST-segment depressions in ECG after angiography in ACS patients are associated with a significantly higher long-term risk for SCD and SCA.

查看原文本刊更多论文

急性冠状动脉综合征后st段压低与心源性猝死和骤停之间的关系

研究目的：急性冠脉综合征（ACS）患者心电图st段下降与较高的死亡率相关。但是，其与心源性猝死（SCDs）或心源性骤停（SCAs）的关系尚未被研究。我们分析了ACS患者血管造影后心电图st段下降与SCD和SCA长期发病率之间的关系。方法：回顾性分析8565例ACS患者的资料，中位随访时间为7.1年。根据st段凹陷的位置，分层后比较血管造影后心电图出现st段凹陷患者（n = 1957）和未出现st段凹陷患者（n = 6608）。scd和sca事件的裁决使用了各种来源，详细说明了导致事件的情况。关联分析采用亚分布回归（Fine-Gray）模型。结果：在年龄和性别调整分析中，侧、下、下st段压低与SCD和SCA的长期风险相关（p值）。结论：ACS患者血管造影后心电图显示的侧、下、下st段压低与SCD和SCA的长期风险显著升高相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of electrocardiology 医学-心血管系统

CiteScore

2.70

自引率

7.70%

发文量

152

审稿时长

38 days

期刊介绍： The Journal of Electrocardiology is devoted exclusively to clinical and experimental studies of the electrical activities of the heart. It seeks to contribute significantly to the accuracy of diagnosis and prognosis and the effective treatment, prevention, or delay of heart disease. Editorial contents include electrocardiography, vectorcardiography, arrhythmias, membrane action potential, cardiac pacing, monitoring defibrillation, instrumentation, drug effects, and computer applications.