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Objective:To explore the relation betweenK469E gene polymorphism of intercellular adhesion molecular-1(ICAM-1) and the recurrence ofACS and cardiovascular mortality.Methods:A total of185 patients withACS hospitalized inDepartment ofCardiology in our hospital fromSep2007 toSep2008 were selected as objectives.Polymerase chain reaction was used to analyzeK469E gene polymorphism ofICAM-1.According to the genotypes, they were divided into two groups: group withK allele(KK+KE) and group withoutK allele(EE).The two groups were followed up prospectively for five years and blood lipid, blood pressure, blood glucose, recurrence and death ofACS were collected when the patients left hospital.The relation betweenICAM-1 gene polymorphism and the recurrence ofACS and cardiovascular mortality was analyzed byLogistic regression.Results:After long-term follow-up, it was found thatACS recurred on71 cases (38.4%) and10 cases died, among which3 cases died of cardiovascular disease.The recurrence ofACS and cardiovascular mortality in group withK allele were remarkably higher than that in group withoutK allele(P<0.01).After multivariateLogistic regression adjusted ages, gender, weight indexes,TC,LDL-C,TG, smoking, drinking, family history of cardiovascular disease, history of hypertension and the severity of coronary artery disease, the risks ofACS recurrence and cardiovascular mortality in group with genotypeKK+KE was3.31 and3.53 times of those in group with genotypeEE respectively(P<0.01).When the independent variable of hypertension was introduced in regression analysis, the risks ofACS recurrence and cardiovascular mortality in group withK allele both decreased(P<0.05).When the independent variable ofHDL-C was introduced, different genotypes ofICAM-1 weren’t relevant withACS recurrence and cardiovascular mortality(P>0.05).Conclusions:K469E gene polymorphism ofICAM-1 was related toACS recurrence and cardiovascular mortality,K allele probably an independentrisky factor and hypertension and to which the level ofHDL-C were closely related.