AIMS: We evaluated whether short-term depressive symptoms are associated with the 30-day prognosis of hospitalized patients presented with acute coronary syndromes (ACS). METHODS: A sample of 6 hospitals located in Greek urban and rural regions was selected. From October 2003 to September 2004, we recorded the non-fatal admissions of ACS. Assessment of depressive symptoms, during past month, was based on the CES-D scale (Radloff S., 1977). RESULTS: 2172 patients were included in the study (1649, 76% were males). The mean CES-D score was 13.5+/-12 in male patients and 13.6+/-12 in females (p=0.89). Compared to patients with angina those who had non-Q-wave MI or Q-wave MI had higher CES-D score (12.3+/-11.6 vs. 15.3+/-12.8 vs. 13.2+/-11.9, p=0.001). The number of events during the first 30-day following discharge was 9.2% in males and 9.7% in females. Multivariable logistic regression analysis revealed that 1-unit increase in CES-D was associated with 10% higher odds (95% CI 1.09-1.12) of re-current events (death or re-hospitalization), after adjusting for various socio-demographic, lifestyle and clinical factors. CONCLUSION: We revealed that short-term depressive symptoms are related to more severe disease and a worsen 30-day prognosis of patients hospitalized for ACS.