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Background Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) is an acute heart disease caused by incomplete occlusion of related coronary arteries with unstable atherosclerotic plaques.Lead aVR ST-segment elevation and cTnI positive are closely correlated to the prognosis of NSTE-ACS patients.However,there are few studies applying the two predictors to early risk stratification in NSTE-ACS patients.Method Two hundred and five cases of NSTE-ACS patients followed up for 6 months after discharge were reviewed.All patients were divided into four groups:Group A-cTnI negative combined with aVR-non-ST-segment elevation group (100 cases);Group B-cTnI negative combined with aVR-ST-segment elevation group (31 cases);Group C-cTnI positive combined with aVR-non-ST-segment elevation group (43 cases);Group D-cTnI positive combined with aVR-ST-segment elevation group (31 cases).There was no significant difference in gender,age,old myocardial infarction,previous PCI history,hypertension,and diabetes between aVR-ST elevation group and no aVR-ST elevation group.The morbidity of left main or three-vessel coronary artery disease as well as adverse cardiovascular events in the four groups were observed and analyzed.Results (i) The morbidity of left main or three-vessel coronary artery disease was highest in Group D (87.1％),and was markedly higher in Group B (41.9％) than that in Group A (7％) or Group C (9.3％);(ii) The incidence of adverse cardiovascular events was highest in Group D (77.4％),and was much higher in B (35.5％) as compared with that tin Group A (1％) or group C (7％).Conclusion Electrocardiographic lead aVR ST-segment elevation combined with cTnI positive has an important clinical value in predicting the prognosis of the patients with NSTE-ACS.