Objective To investigate the influencing factors of major adverse cardiovascular events(MACE)in the prognosis of patients with acute coronary syndrome(ACS).Methods A total of 200 patients with acute coronary syndrome admitted to the hospital from February 2019 to February 2022 were followed up for 1 year to observe the occurrence of MACE,and were grouped according to the follow-up results.General data[gender,age,body mass index(BMI),smoking history,drinking history,basic complications(hypertension,diabetes),family history of cardiovascular disease],clinical indicators(number of coronary artery lesions,number of stents implanted),cardiac function indicators[left ventricular ejection fraction(LVEF)],laboratory indicators[creatine kinase isoenzyme(CK-MB),troponin T(cTnT)].Draw receiver operating characteristic(ROC)curves to analyze the value of predicting MACE in ACS patients based on the number of coronary artery lesions,LVEF,CK-MB,and cTnT.Using multiple logistic regression analysis to identify the risk factors for MACE in ACS patients.Results After 1 year of follow-up,there were 40 cases(20.00%)in the MACE group and 160 cases(80.00%)in the non MACE group.There was no significant difference in gender,age,BMI,smoking history,drinking history,hypertension,diabetes,family history of cardiovascular disease,and the number of stents implanted between the two groups(P>0.05).The number of coronary artery lesions in the group with MACE was higher than that in the group without MACE(P<0.05),LVEF was lower than that in the group without MACE(P<0.05),and CK-MB and cTnI were higher than those in the control group(P<0.05).ROC analysis confirmed that LVEF,CK-MB,and cTnI can all predict the occurrence of MACE in ACS patients,with areas under the curves of 0.763,0.960,and 0.914,respectively(P<0.05).Multivariate logistic regression analysis showed that the number of coronary artery lesions was>1,LVEF≤ 53.35%,CK-MB≥173.81 U·L-1,and cTnI ≥0.62 μg·L-1 was risk factors for the occurrence of MACE in ACS patients(P<0.05).Conclusion The number of coronary artery lesions was>1,LVEF ≤53.35%,CK-MB≥173.81 U·L-1,and cTnI≥0.62 μg·L-1 was risk factors for the occurrence of MACE in ACS patients.