EKG vs. SMST

Last updated Jul 17, 2026

EKG (First Trust Nasdaq Lux Digital Health Solutions ETF) and SMST (Defiance Daily Target 2X Short MSTR ETF) are both exchange-traded funds - EKG is a Health & Biotech Equities fund tracking the NASDAQ Lux Health Tech Index, while SMST is a Inverse Equities fund actively managed by Defiance. EKG is passively managed, while SMST is actively managed. Over the past year, EKG returned 13.99% vs 257.89% for SMST. At a correlation of -0.34, they often move in opposite directions. EKG charges 0.65%/yr vs 1.29%/yr for SMST.

Performance

EKG vs. SMST - Performance Comparison

The chart below illustrates the hypothetical performance of a $10,000 investment in First Trust Nasdaq Lux Digital Health Solutions ETF (EKG) and Defiance Daily Target 2X Short MSTR ETF (SMST). The values are adjusted to include any dividend payments, if applicable.

Returns By Period

In the year-to-date period, EKG achieves a 3.37% return, which is significantly higher than SMST's -31.71% return.

EKG

• 1D: -0.11%
• 1M: 11.09%
• 6M: -0.16%
• YTD: 3.37%
• 1Y: 13.99%
• 3Y*: 2.05%
• 5Y*: —
• 10Y*: —

SMST

• 1D: 7.64%
• 1M: 37.45%
• 6M: -8.12%
• YTD: -31.71%
• 1Y: 257.89%
• 3Y*: —
• 5Y*: —
• 10Y*: —

*Multi-year figures are annualized to reflect compound growth (CAGR)

EKG vs. SMST - Yearly Performance Comparison

	2026 (YTD)	2025	2024
EKG First Trust Nasdaq Lux Digital Health Solutions ETF	3.37%	11.89%	4.21%
SMST Defiance Daily Target 2X Short MSTR ETF	-31.71%	-44.36%	-91.71%

Correlation

The correlation between EKG and SMST is -0.28, meaning they tend to move in opposite directions. This is especially valuable for risk management - when one declines, the other has historically tended to hold steady or rise.

	Correlation
Correlation (1Y) Calculated over the trailing 1-year period	-0.28
Correlation (All Time) Calculated using the full available price history since Aug 21, 2024	-0.34

Return for Risk

EKG vs. SMST — Risk / Return Rank

Compare risk-adjusted metric ranks to identify better-performing investments over the past 12 months.

EKG

EKG Risk / Return Rank: 20
EKG Sharpe Ratio Rank: 21
EKG Sortino Ratio Rank: 22
EKG Omega Ratio Rank: 21
EKG Calmar Ratio Rank: 19
EKG Martin Ratio Rank: 18

SMST

SMST Risk / Return Rank: 63
SMST Sharpe Ratio Rank: 67
SMST Sortino Ratio Rank: 64
SMST Omega Ratio Rank: 64
SMST Calmar Ratio Rank: 75
SMST Martin Ratio Rank: 44

The rank (0–100) shows how this investment's returns compare to the risk taken. Higher = better. Based on the past 12 months of data, combining Sharpe, Sortino, and other metrics used by quantitative funds and institutional investors.

EKG vs. SMST - Risk-Adjusted Trends Comparison

This table presents a comparison of risk-adjusted performance metrics for First Trust Nasdaq Lux Digital Health Solutions ETF (EKG) and Defiance Daily Target 2X Short MSTR ETF (SMST). Risk-adjusted metrics are performance indicators that assess an investment's returns in relation to its risk, enabling a more accurate comparison of different investment options.

Values are calculated on a 1-year rolling basis and updated daily. Risk-adjusted metrics are more stable over longer periods — use the period switch above to explore them.

	EKG	SMST	Difference
Sharpe ratio: Return per unit of total volatility	0.61	1.74	-1.13
Sortino ratio: Return per unit of downside risk	1.01	2.38	-1.37
Omega ratio: Gain probability vs. loss probability	1.12	1.31	-0.19
Calmar ratio: Return relative to maximum drawdown	0.64	3.04	-2.41
Martin ratio: Return relative to average drawdown	1.37	5.82	-4.45

EKG vs. SMST - Sharpe Ratio Comparison

The current EKG Sharpe Ratio is 0.61, which is lower than the SMST Sharpe Ratio of 1.74. The chart below compares the historical Sharpe Ratios of EKG and SMST, calculated using daily returns over the previous 12 months. A higher Sharpe Ratio indicates better risk-adjusted performance relative to the risk-free rate.

Drawdowns

EKG vs. SMST - Drawdown Comparison

The maximum EKG drawdown since its inception was -43.82%, smaller than the maximum SMST drawdown of -99.25%. Use the drawdown chart below to compare losses from any high point for EKG and SMST.

Drawdown Indicators

	EKG	SMST	Difference
Max Drawdown Largest peak-to-trough decline	-43.82%	-99.25%	+55.43%
Max Drawdown (1Y) Largest decline over 1 year	-22.09%	-85.39%	+63.30%
Max Drawdown (3Y) Largest decline over 3 years	-34.11%	—	—
Current Drawdown Current decline from peak	-8.91%	-97.32%	+88.41%
Average Drawdown Average peak-to-trough decline	-22.41%	-90.93%	+68.52%
Ulcer Index Depth and duration of drawdowns from previous peaks	10.22%	44.56%	-34.34%

Volatility

EKG vs. SMST - Volatility Comparison

The current volatility for First Trust Nasdaq Lux Digital Health Solutions ETF (EKG) is 8.58%, while Defiance Daily Target 2X Short MSTR ETF (SMST) has a volatility of 55.38%. This indicates that EKG experiences smaller price fluctuations and is considered to be less risky than SMST based on this measure. The chart below showcases a comparison of their rolling one-month volatility.

Volatility by Period

	EKG	SMST	Difference
Volatility (1M) Calculated over the trailing 1-month period	8.58%	55.38%	-46.80%
Volatility (6M) Calculated over the trailing 6-month period	18.55%	135.32%	-116.77%
Volatility (1Y) Calculated over the trailing 1-year period	23.08%	149.40%	-126.32%
Volatility (5Y) Calculated over the trailing 5-year period, annualized	27.14%	167.53%	-140.39%
Volatility (10Y) Calculated over the trailing 10-year period, annualized	27.14%	167.53%	-140.39%

EKG vs. SMST - Expense Ratio Comparison

EKG has a 0.65% expense ratio, which is lower than SMST's 1.29% expense ratio.

Dividends

EKG vs. SMST - Dividend Comparison

Neither EKG nor SMST has paid dividends to shareholders.

Tickers have no history of dividend payments

Frequently Asked Questions

Can I hold both EKG and SMST in my portfolio?

EKG and SMST have a correlation of -0.28, meaning they provide meaningful diversification benefit when combined. Depending on your allocation goals, holding both could reduce overall portfolio risk.

Which is riskier, EKG or SMST?

SMST has higher volatility (55.38%) compared to EKG (8.58%). In terms of maximum drawdown, EKG dropped -43.82% vs SMST's -99.25%.

Which ETF is better, EKG or SMST?

On 1-year performance, SMST leads with 257.89% vs 13.99% for EKG. On fees, EKG is cheaper at 0.65% per year. On volatility, EKG has been the lower-risk option at 8.58%. The better choice depends on whether you care most about return, fees, risk, or income.

Which ETF has performed better, EKG or SMST?

Over the 1-year period, SMST has performed better with a 257.89% return vs 13.99%. Past performance does not guarantee future results, so compare this with risk, fees, and fund exposure.

Which ETF is cheaper, EKG or SMST?

EKG is cheaper with a 0.65% expense ratio, compared with 1.29% for SMST.

Which ETF pays a higher dividend yield, EKG or SMST?

EKG and SMST have nearly identical dividend yields, around 0.00%.

What is the main difference between EKG and SMST?

EKG is categorized as Health & Biotech Equities, while SMST is Inverse Equities. They also come from different issuers: First Trust and Defiance. Their fees differ too: 0.65% for EKG and 1.29% for SMST.

Which has better risk-adjusted returns?

SMST currently has the higher Sharpe Ratio (1.74 vs 0.61), meaning it's delivered slightly more return per unit of risk over the trailing 12 months. However, this ranking shifts over time - use the Risk/Return Score above for a more comprehensive view that combines Sharpe, Sortino, and other measures used by quantitative funds.