{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:39:50Z","timestamp":1786649990391,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background:<\/jats:title>\n Intraoperative cardiac complications may result from an imbalance between myocardial oxygen supply and demand or from plaque rupture. Electrocardiographic (ECG) alterations in the ST-segment observed during surgery or anesthesia can serve as indicators of myocardial ischemia. Numerous factors influence ST-segment variability. This study aimed to investigate the incidence of ST-segment changes and the factors associated with their occurrence.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This prospective observational study enrolled adult patients (aged \u2265 20 years) undergoing noncardiac surgery under general anesthesia. Intraoperative ST-segment monitoring was performed using a five-electrode system. Predisposing factors for ischemia, including hemodynamic parameters, coexisting diseases, and surgical characteristics, were evaluated. A\n P<\/jats:italic>\n -value of <0.05 was considered statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 102 patients were evaluated, with a mean age of 46.75 \u00b1 16.30 years, comprising 46 males (45.1%). Postinduction ST-segment depression was greater than preinduction (\u22120.030 to \u2212 0.055 vs. 0.010 to 0.060, respectively) (\n P<\/jats:italic>\n = 0.0 01). ST-segment values were significantly more depressed in patients with underlying conditions, particularly hypertension and diabetes mellitus (\n P<\/jats:italic>\n = 0.001). Also, the variations in ST-segment alteration were considerable among minor and major surgeries (\n P<\/jats:italic>\n = 0.041). Overall, 20 patients (19.6%) exhibited prominent ST-segment changes (greater than 0.1 mV) during surgery; however, the changes were predominantly transient and managed successfully with initial clinical interventions (e.g., fluid administration). While postinduction blood pressure showed a significant drop, no statistical association was observed between the magnitude of blood pressure changes and the occurrence of ST-segment changes (\n P<\/jats:italic>\n = 0.10). No significant relationship was identified between ST-segment changes and other evaluated factors.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The intraoperative ST-segment changes occurred following anesthetic induction and are significantly correlated with predisposing factors, specifically hypertension, diabetes mellitus, and major vs. minor surgeries. Despite significant hemodynamic alterations during the procedure, a direct correlation with prominent ST-segment changes could not be statistically established. Given the transient nature of most alterations, further studies incorporating postoperative troponin measurement and long-term follow-up are warranted to clarify the clinical significance of these intraoperative findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aca.aca_243_25","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T19:01:06Z","timestamp":1777489266000},"page":"352-358","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and Associated Factors of ST-Segment Changes in Noncardiac Surgery Under General Anesthesia"],"prefix":"10.4103","volume":"29","author":[{"given":"Mehryar Taghavi","family":"Gilani","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabiolah","family":"Mafi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Mashhadi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samaneh S. 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