Background: Although mitral inflow velocity over early mitral annulus velocity (E/E���), a surrogatemarker of left ventricular filling pressure, was shown to be a good prognostic predictor of survival in patients with acute myocardial infarction (MI), it is unknown whether systolic mitral annulus velocity (S���) will provide incremental information for predicting prognosis in patients with acute myocardial infarction (MI). We hypothesized that S��� will provide additional prognostic information to E/E���. Methods: Five hundred patients (mean age 62.8짹12.0, male 356) with acute MI who had comprehensive echocardiographic examination were prospectively enrolled. The end point was death and admission due to heart failure. Results: Mean follow-up duration was twelve months. During follow-up, 46 cardiac events were occurred (33 death, 13 heart failure). Patients were classified into 4 groups based on E/E��� and S��� (group 1: E/E���<15 & S���>5; group 2, E/E���<15 & S���<5; group 3, E/E���>15 & S���>5; group4, E/E���> 15 & S���<5). There was graded difference of cardiovascular outcome between the groups. In multivariable Cox analysis, the addition of S���<5 cm/s significantly improved the outcome of a model that containing E/E���>15 cm/s (global chi-square increased from 16.6 to 27.0, p=0.003). Conclusion : S��� is an independent predictor of cardiac event in patients with acute MI and provide additional prognostic value to E/E���.