Non-ST segment elevation coronary syndrome: Prognostic value of the sum of the magnitude of ST segment depression

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Published Jul 12, 2026
https://doi.org/10.62438/tunismed.v104i07.6461
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Vol. 104 No. 07 (2026): Tunis Med Jul 2026

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Héla Ben Turkia
Regional hospital of Ben Arous, Faculty of Medecine of Tunis, University of Tunis El Manar, Tunis, Tunisia
https://orcid.org/0000-0002-3364-3067
Hanene Ghazali
Regional hospital of Ben Arous, Faculty of Medecine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Syrine Keskes
Regional hospital of Ben Arous, Faculty of Medecine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Ines Chermiti
Regional hospital of Ben Arous, Faculty of Medecine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Mouna Gamoudi
Regional hospital of Ben Arous, Faculty of Medecine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Sami Souissi
Regional hospital of Ben Arous, Faculty of Medecine of Tunis, University of Tunis El Manar, Tunis, Tunisia

Abstract

Introduction: ST segment depression is a highly predictive marker of mortality in non-ST-segment elevation acute coronary syndrome (NSTEMI).
The aim of our study was to evaluate the prognostic value of the magnitude and the cumulative sum of ST depression in NSTEMI in term of major cardiovascular events (MACE) at six months.
Methods: A retrospective observational study was conducted over six years. We included NSTEMI patient with ST segment depression > 0.5 mm in at least on lead. The cumulative sum of ST-segment depression was calculated of each patient. Evaluation of MACE (Death, stroke, Myocardial
infarction, Major bleeding, recurrent angina) was performed six months. logistic regression model was developed to assess the prognostic value of the magnitude and distribution of ST segment depression in predicting MACE.
Results: Inclusion of 287 patients. Mean age = 62±11 years. Sex ratio = 1.7. Comorbidities (%): hypertension (59), diabetes (45), dyslipidemia (33), coronaropathy (28). Mean ST segment depression = 5±4.5 mm. MACE were found in 27% of patients. Mean cumulative sum in patients how
developed MACE at six months was 6.5±5 mm versus 4±3.3 mm in not MACE (p<0.001). In multivariate analysis a cumulative sum of ST-segment depression >7 mm (aOR = 5.34, p <0.001, 95% CI [2.71; 10.51]) were independently associated with MACE at six months. Positive correlation was found between the sum of ST segment depression, the number of leads with ST segment depression and the severity of coronary artery disease with (r=0.352; p<0.001) ....( abstract truncated at 250 words).

Keywords:

Myocardial infarction, Prognosis, Emergency, Electrocardiogram (ECG)

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