Background and Objectives:Whether uric acid is a predictor of cardiovascular events remains controversial. Wesought to evaluate the effects of the serum uric acid levels on major adverse cardiovascular events (MACEs) inthe patients with coronary artery disease (CAD). Subjects and Methods:The study population consisted of 660consecutive patients with CAD, and they were followed up for a mean of 27 months (maximum: 62 months). Therecorded MACEs included acute myocardial infarction (AMI), stroke, coronary artery bypass graft, percutaneouscoronary intervention (PCI) due to de novo lesion during follow up, congestive heart failure (CHF) and suddencardiac death. Results:In the CAD patients with a uric acid level ≤3.88 mg/dL (the lowest quartile), as comparedwith those CAD patients with uric acid levels >5.74 mg/dL (the highest quartile), the MACE rate increased from7.2% to 20.1%. On univariate Cox regression analysis, the highest uric acid quartile was a predictor of AMI, CHFand MACE. The absolute serum uric acid level was predictive of PCI, CHF and MACE. Multivariate Cox regressionanalysis showed that the independent predictors of MACE were presentation with acute coronary syndrome (HR1.70, 95% CI: 1.04 to 2.78, p=0.033), multi-vessel disease (HR 2.43, 95% CI: 1.44 to 4.12, p=0.001), and the uricacid levels (HR 1.22, 95% CI: 1.05 to 1.43, p=0.010), and the highest uric acid quartile (HR 2.54, 95% CI: 1.58 to4.10, p<0.001). Conclusion:The serum uric acid level and multi-vessel disease are associated with subsequentcardiovascular events in the patients with CAD. (Korean Circulation J 2007;37:161-166)