Background and Objectives : Left ventricular (LV) remodeling is a dynamic and complex process that occurs in response to damage to the myocardium after myocardial infarction (MI). Plasma N-terminal Pro-B type Natriuretic Peptide (pro-BNP) have a prognostic power in patients with acute myocardial infarction (AMI). The aim of this study is to evaluate whether pro-BNP on admission can predict LV remodeling after ST-elevation myocardial infarction (STEMI) Materials and Methods : Seventy four patients who visited Yeungnam University Hospital from March 2004 to July 2006 and diagnosed as first STEMI were enrolled. Plasma Pro-BNP , high sensitivity C-reactive protein (hs-CRP), and echocardiographic parameters were measured on admission and at 6 months after discharge. LV remodeling was defined as a ��� 20 % increase in end-diastolic volume index (LVEDVi) between baseline and 6 months follow up. Group 1 (n=23) was defined as presence of remodeling and Group 2 (n=51) was defined as absence of remodeling. Results Baseline characteristics between two groups were not statistically different. Medications as beta blockers, angiotensin receptor antagonists, angiotensin converting enzyme inhibitors and statins were used similar in both groups. Baseline pro-BNP levels were lower in Group 2 than Group 1 (686짹618 pg/ml vs 1494짹1331 pg/ml, p=0.04). Follow up pro-BNP and hsCRP levels were not significantly different between two groups. In multivariate analysis, pro-BNP on admission (p=0.04, OR=1.0) and LVEDVi (p=0.002, OR=1.26) were independent risk factor for LV remodeling. Conclusions : Pro-BNP on admission is an independent predictor of LV remodeling in patients with ST elevation myocardial infarction. KEY WORDS : Pro-B type natriuretic peptide, Remodeling, Acute myocardial infarction