Purpose: Leukotriene B4 (LTB4) and extracellular matrix metalloproteinase (EMM-PRIN) have been suggested as modulators of atherosclerotic plaque instability. is study sought to evaluate the potential diagnostic implication of LTB4 and EMMPRIN in patients with acute coronary syndrome (ACS).Methods: Patients (n=153) who underwent coronary angiography, including 105 patients diagnosed with ACS, were divided into four groups: stable angina pectoris (SAP, n=19), unstable angina pectoris (UAP, n=39), acute myocardial infarction (AMI, n=66) and control (with normal coronary angiography, n=29). EMMPRIN expression in peripheral blood mononuclear cells was determined by ow cytometry and serum LTB4 levels were measured by ELISA. To examine whether LTB4 can regulate the expression of EMM-PRIN and matrix metalloproteinases (MMPs) in macrophages, di erentiated THP-1 macrophages were stimulated with di erent concentrations of LTB4 (10-10-10-7mmol/ L). Expression of EMMPRIN was evaluated by Western blotting. MMP-9 mRNA expression and enzymatic activity were determined by RT-PCR and SDS-PAGE gelatin zymography.Result: Serum LTB4 concentration was signi cantly higher in AMI and UAP groups, compared with control and SAP groups (p<0.01). Subgroups analysis showed that LTB4 was signi cantly higher in the AMI<24h group, compared with the AMI>24h group. Expression of EMMPRIN on circulating monocytes was signi cantly higher in patients with UAP and AMI (>24h), compared with control, SAP and AMI (<24h) groups (p<0.05). In vitro study showed LTB4 up-regulated the expression of EMMPRIN, as well as the expression and activity of MMP-9, in cultured THP-1-derived macrophages (p<0.05).Conclusion: LTB4 and EMMPRIN are associated with the pathogenesis of ACS and may be potential biomarkers for patients with ACS.