Background and Objectives : The mortality rate of complicated acute myocardial infarction (AMI) patients who required artificial ventilator and/or intra-aortic balloon pump (IABP) at coronary care unit (CCU) was reported very high. The aims of this study were to evaluate the mortality rate and investigate the predictors of in-hospital death in these critically ill patients. Subjects and Methods : A total of 134 complicated AMI patients who were treated with artificial ventilator and/or IABP at CCU of Chonnam National University Hospital between January 2004 and December 2005, were retrospectively analyzed. We compared the clinical characteristics, laboratory, echocardiographic, coronary angiographic findings and the Global Registry of Acute Coronary Event (GRACE) score between survivors and non-survivors. Results : The following parameters were univariate predictors of in-hospital mortality: diabetes, hyperlipidemia, Killip class≧III, cardiogenic shock, acute pulmonary edema, percutaneous coronary intervention (PCI), left circumflex artery lesion, the extent of coronary artery disease, use of IABP, high GRACE score, and high levels of high sensitivity C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) (p<0.05, respectively). On multivariate analysis, use of IABP (odds ratio, 4.2; 95% CI;1.22���14.36, p=0.022) and high GRACE score (odds ratio, 1.03; 95% CI;0.99���1.06, p=0.050) were still remained independent predictors of in-hospital mortality. Conclusions : The predictive factors for hospital death in patients with AMI treated by IABP and/or artificial ventilator at CCU were use of IABP and high GRACE score.