Coronary disease & ACSCohort study
Multistage Electrocardiographic Profiling for Mental Stress-Induced Myocardial Ischemia in Women: A Prospective, Age-Matched Cohort Study in China
- Prospective, Age-Matched Cohort Study
- single-center tertiary hospital
- machine learning
Authors' conclusion
Multistage ECG analysis, particularly heart rate variability, captures electrophysiological signatures of mental stress-induced myocardial ischemia and enhances noninvasive detection. These findings support a paradigm shift from single-phase, ischemia-focused ECG interpretation to dynamic, multivariable assessment, providing a foundation for early identification and personalized risk stratification in women with nonobstructive coronary disease.
Study context
- Population
- Women (18–75 years) with angina, nonobstructive coronary artery disease, and age-matched healthy controls, Guangzhou, Chinastudy cohort 119 · test cohort 53
- Participants
- 119 vs 53
- Exposure
- Machine learning classifiers using single-stage, multistage, and interstage ECG features against positron emission tomography/computed tomography labeling of mental stress-induced myocardial ischemia
- study cohortn = 119
- test cohortn = 53
Main finding
As reported in the abstract
Intrastage features differing across Rest, Stress, and Recovery
study cohort
103 of 264
events
- significant heart rate variability, heart rate asymmetry, and prognostic-related changes
- P < 0.05
Observational data: associations, not effects.
Further findings
| Outcome | study cohort | test cohort |
|---|---|---|
| Interstage features showing significant group differences | 73 of 264 events | Not reported in the abstract |
Model performance in test cohort
- models using multistage and interstage features all outperformed single-stage models
- mean age 53±7 years
Original publication
Multistage Electrocardiographic Profiling for Mental Stress-Induced Myocardial Ischemia in Women: A Prospective, Age-Matched Cohort Study in China. Circ Popul Health Outcomes. Published 16 February 2026. doi:10.1161/circoutcomes.125.012750
Summarised from the published abstract; every number is checked against it