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Background: High-sensitivity C-reactive protein (hs-CRP) is a major factor for predicting acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In the present work, a detail comparison between MPO and hs-CRP for early warning ACS is discussed. Objective: To compare the values between MPO and hs-CRP for early warning ACS and predicting major adverse cardiovascular events (MACEs) in CHD patients. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS and 210 non-ACS patients were tested, and data were analyzed with SPSS software. Major adverse cardiovascular events (MACEs) were investigated during the 4-year period follow-up in 285 coronary heart disease (CHD) patients. Results: The areas under receiver operating characteristic (ROC) curve for diagnosing ACS were 0.888 (95% Cl 0.843-0.933) for MPO, and 0.862 (95% Cl 0.815-0.910) for hs-CRP, respectively. Compared to hs-CRP, MPO had more correlations strongly with ACS-related risk factors of TG, HDL-C and LDL-C in ACS patients (p<0.05). Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383,95% Cl 4.095-13.309) and high hs-CRP baseline level (yes vs no, OR 4.186,95% Cl 2.469-7.097). Conclusions: MPO as inflammatory marker for early warning ACS has some advantages compared to hs-CRP. Elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients.