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Background Macrophage migration inhibitory factor (MIF) is involved in the progress of atherosclerosis and plaque destabilization and plays a pivotal role in the development of ST-segment elevation myocardial infarction (STEMI).The aim of the present study was to study on the characteristics of MIF in time-dependent changes, to evaluate the diagnostic value of MIF for early STEMI (≤4 hours of onset) and late STEMI (＞4 hours after onset), and determine whether MIF can predict major adverse cardiovascular events (MACE) in the patients with STEMI while in the hospital, compared with admission global registry of acute coronary events (GRACE) risk score.