Background: Patients with ST segment elevation in the aVR lead were divided into major and minor groups and compared with respect to blood lipid levels, admission glucose levels, angiography results and prognosis.

Methods: The clinical data of the study was obtained by a retrospective review of the charts of 887 patients (550 males, 337 females) with aVR elevation, who were admitted to our emergency department between January 2004 and December 2008 with chest pain and hospitalized in the cardiology ward. The patients were divided into minor (group 1; 0.5-1 mm) and major (group 2; >1 mm) groups according to the ST segment elevation in aVR and compared with respect to age, gender, emergency room arrival time, blood glucose level, lipid profile, ejection fraction (EF), angiography results, Gensini score, and mortality rates.

Results: Group 2 had a significant correlation with male gender, increased Gensini score, low EF, high blood glucose level, number of myocardial infarction patients with ST segment elevation, three-vessel disease and high mortality (p<0.05). Group 2 patients also had a worse prognosis.

Conclusion: Early revascularization and/or medical treatment may be effective in the prognosis of patients with acute coronary syndrome diagnosis and a 1-mm or higher ST segment elevation in the aVR lead.

Keywords : Acute coronary syndrome; emergency service; gensini score; mortality; ST segment elevation in aVR lead