Objective To investigate the prognostic value of N-terminal pro-brain natriuretic peptide(NT-proBNP) combined with soluble CD40 ligand(sCD40L) in acute coronary syndrome(ACS) patients.Methods A total of 134 ACS patients were enrolled:seventy patients with ST elevation myocardial infarction,8 patients with non-ST elevation myocardial infarction,and 56 patients with unstable angina.Plasma NT-proBNP and sCD40L were measured by ELISA obtained between 12-24h after admission.According to the ROC curve,the cut-off value of NT-proBNP and sCD40L was 1 163.89 pmol/L and 915μg/L respectively.And,according to NT-proBNP combined with sCD40L results the patients were divided into 3 groups.In addition,the patients with ACS were evaluated during the in-hospital period and followed-up for(96.62±9.08)d for major adverse cardiac events(MACE).Results The incidence of MACE was significantly higher in high concentration(n=41) than that in low concentration of NT-proBNP group(n=93)(48.8% vs 4.3%,P<0.01).The incidence of MACE was higher in high concentration sCD40L group(n=57) than that in low concentration one(n=77)(28.1% vs 10.4%,P<0.01).The morbidity of MACE was 56.5%,19.2% and 1.7%,respectively,in positive group(high concentration of both NT-proBNP and sCD40L),weakly positive group(one marker with high concentration),and negative group(with low concentration of both markers).Conclusion The combination of NT-proBNP and sCD40L adds critical prognostic insight to the assessment of patients with ACS.