The correlation between presenting ST-segment depression and the final size of acute myocardial infarcts in patients with acute coronary syndromes

The use of reperfusion therapy in patients with ST elevation acute coronary syndromes had been established. However, reperfusion therapy is usually co nsidered contra-indicated in those with ST depression, despite the knowledg e that regional posterior infarction is typically indicated by ST depressio n maximal in leads V-1 to V-3 and nonregional subendocardial infarction is typically indicated by marked ST depression maximal in other leads. This st udy of patients with non-ST-elevation acute coronary syndromes investigates the quantitative relationship between presenting ST depression and final Q RS changes in both of these subgroups. The final QRS score was significantl y higher (2.44 points) than that of a control group with not ST depression, (1.55 points) in the group with maximal ST depression in V-1 to V-3 (P = 0 .04). However, in the entire population, there was a highly significant cor relation (P = .003) between the sum of the presenting ST depression and the final QRS score. Trials of reperfusion therapy will he required to determi ne if such evolution to electrocardiogram documented acute myocardial infar ction can be prevented in patient with marked ST depression acute coronary syndromes.