Background: High-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (NTproBNP) have been known to be independent predictors of cardiovascular events in patients with coronary artery disease. However, the combined use of these two biomarkers for predicting poor clinical outcomes in patients with acute myocardial infarction (AMI) has not been well described. Methods: As part of the Korean AMI Registry, we analyzed 5,425 eligible patients with AMI treated with percutaneous coronary intervention (PCI), from November 2005 to January 2008. Patients with cardiogenic shock or underlying malignancy were excluded, and 5,130 (62.7 짹 12.4 years, male 73 %) patients were included in the final analysis. Plasma levels for hsCRP and NT-proBNP were measured before PCI. Patients were categorized into four groups by using median values of hsCRP (0.94 mg/dL) and NT-proBNP (437 pg/mL): group I, low hsCRP/low NT-proBNP (n=1,654); group II, high hsCRP/low NT-proBNP (n=936); group III, low hsCRP/high NT-proBNP (n=939); group IV, high hsCRP/high NT-proBNP (n=1,601). Results: During the 1 year follow-up, there were 234 composite major cardiac events at 1 month (4.8%) and 223 deaths at 1 year (4.9%): 2.2%, 2.4%, 5.5% and 8.4% of 1 month composite major cardiac events (p<0.001) and 1.2%, 2.5%, 5.5% and 9.9% of 1 year deaths (p<0.001) occurred from group 1 to 4, respectively. Spearman correlation analysis revealed significant associations between levels of hsCRP and NT-proBNP (rho=0.358, P<0.001). In a Cox proportional hazard model, after adjusting for standard risk factors, the combined use of hsCRP and NT-proBNP significantly increased predictive value for 1 year mortality (hazard ration 3.792, 95% confidence interval 1.779-8.083; p<0.001 for high hsCRP/high NT-proBNP vs. low hsCRP/low NT-proBNP). Other independent predictors of 1 year mortality included age ��� 75, 60 ��� age < 75, heart rate > 100 beats/min, Killip class > 1, left ventricular ejection fraction < 55% and creatinine >1.3 mg/dL. Conclusions: Simple combination of distinct biomarkers of hsCRP and NT-proBNP provides additional information for predicting clinical outcomes in patients with AMI.