Arrhythmias & electrophysiology
Prevalence and cardiac risk of familial ST depression syndrome: A study of 12 million electrocardiograms
Authors' conclusion
The Fam-STD proband electrocardiographic phenotype is rare and has a prevalence in Denmark of 3-9/100,000, fairly similar to estimates of other inherited arrhythmia syndromes. The increased risk of cardiac events and mortality highlights the importance of early identification to allow preventive interventions.
Study context
- Population
- Individuals aged 15 years or older with electrocardiogram (ECGs) in a Danish nationwide ECG database, excluding ECGs with likely secondary causes of ST-segment deviationsindividuals (6,352,104 ECGs) remaining after exclusions, 55% female, 3.4 ECGs per individual, database contained 11,952,430 ECGs from 2,485,987 unique individuals
- Participants
- 1,890,184 individuals
- Exposure
- Fam-STD-2018, Fam-STD-2022 probands, and Fam-STD-2022 relatives, compared with matched controls without ST deviation
- Fam-STD-2018n = 56
- Fam-STD-2022 probandsn = 173
- Fam-STD-2022 relativesn = 4,975
- Outcome
- Fam-STD phenotype prevalence
Methodological detailsDanish nationwide electrocardiogram (ECG) database, linkage with national registries, Cox proportional hazards models, matched controls without ST deviation
- Danish nationwide electrocardiogram (ECG) database
- Linkage with national registries
- Cox proportional hazards models
- Matched controls without ST deviation
Main finding
As reported in the abstract
Fam-STD-2018
3/100,000
56 of 56
Fam-STD-2022 probands
9/100,000
173 of 173
Fam-STD-2022 relatives
263/100,000
4975 of 4975
Observational data: associations, not effects.
Further findings
| Outcome | Hazard ratio (CI) | |
|---|---|---|
| Composite cardiac end point (new-onset atrial fibrillation, ventricular arrhythmias, heart failure, cardiac device implantation) · mean follow-up of 2.4 ± 3.4 yearsFam-STD-2018vs matched controls without ST deviationIncreased risks | 4.4 (1.2–15.9) | |
| Composite cardiac end point (new-onset atrial fibrillation, ventricular arrhythmias, heart failure, cardiac device implantation) · mean follow-up of 2.4 ± 3.4 yearsFam-STD-2022 probandsvs matched controls without ST deviationIncreased risks | 3.6 (2–6.5) | |
| Composite cardiac end point (new-onset atrial fibrillation, ventricular arrhythmias, heart failure, cardiac device implantation) · mean follow-up of 2.4 ± 3.4 yearsFam-STD-2022 relativesvs matched controls without ST deviationIncreased risks | 2.21 (2–2.5) | |
| All-cause mortality · mean follow-up of 2.4 ± 3.4 yearsFam-STD-2018vs matched controls without ST deviation | 6.2 (3.6–10.6) | |
| All-cause mortality · mean follow-up of 2.4 ± 3.4 yearsFam-STD-2022 relativesvs matched controls without ST deviation | 1.8 (1.7–1.9) | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | Hazard ratio (CI) |
|---|---|
| All-cause mortality · mean follow-up of 2.4 ± 3.4 yearsFam-STD-2022 probands vs matched controls without ST deviation · interval as printed | 3.1 (1.7–1.9) |
Original publication
Prevalence and cardiac risk of familial ST depression syndrome: A study of 12 million electrocardiograms. Heart Rhythm. Published 4 March 2025. doi:10.
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