Patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) are heterogeneous with regard to both underlying disease and prognosis. ST segment depression on admission in NSTE-ACS is considered a powerful predictor of a poor outcome.¹ To clarify the clinical significance of ST segment depression, we studied the relation between the change in ST segment depression after admission, to clinical characteristics and angiographic findings in patients with NSTE-ACS.

METHODS

We studied 190 consecutive patients with NSTE-ACS who had chest pain suggesting cardiac ischaemia within 24 hours before admission, involving an unstable pattern of pain, consisting of rest pain, new onset, severe or frequent angina, accelerating angina, or angina occurring within 21 days after an acute myocardial infarction. A 12 lead ECG was recorded on admission, six hours after admission, and at discharge, at a paper speed of 25 mm/s and an amplification of 10 mm/mV. ST segment depression ⩾ 1.0 mm was considered significant.² ST resolution was defined as a reduction of ⩾ 50% in the sum of ST segment depression in all leads, except for lead aVR, between ECGs on admission and six hours after admission. On admission, C reactive protein concentrations were measured by N Latex CRP Mono tests, performed on a Behring BN II Nephelometer (Behring Diagnostics) using …