Background and Objectives:Serum uric acid has been reported to be an independent risk factor for coronaryartery disease (CAD) and a predictor of mortality in patients with CAD. Yet there is gender difference for theserum uric acid levels. We evaluated the influence of the uric acid levels on major adverse cardiovascular events(MACEs) in patients with CAD according to their gender. Subjects and Methods:Of the 777 patients withangiographically proven CAD, 660 patients (378 males, 57.3%) were followed up a median of 18 month (maximum:61 month). The MACEs included acute myocardial infarction, cerebral infarction, coronary arterybypass graft, percutaneous coronary intervention due to de novo lesion during follow up, new onset congestiveheart failure and sudden cardiac death. Results:MACEs in men were associated with acute coronary syndrome(ACS)(odds ratio (OR): 2.03, 95% confidence intervals (CI): 1.01 to 3.96, p=0.038), multi-vessel disease (OR:3.68, 95% CI: 1.82 to 7.47, p=0.000) and the serum uric acid levels (OR: 1.23, 95% CI: 1.01 to 1.50, p=0.044),according to multivariate Cox regression analysis. For women, MACEs were associated with multi-vessel disease(OR: 2.43, 95% CI: 1.15 to 5.13, p=0.020) and the highest uric acid quartile (OR: 2.64, 95% CI: 1.31 to 5.30,p=0.006) according to multivariate Cox regression analysis. For all patients, the highest uric acid quartile wasassociated with an increased risk of MACE (p=0.000), and CHF was the major contributor to the observedMACEs (p=0.004). Conclusion:In male patients with CAD, the serum uric acid level is a predictor of cardiovascularevents, and the highest uric acid quartile is a predictor of cardiovascular events in women. (KoreanCirculation J 2007;37:196-201)