Background: In acute coronary syndrome, elevated cardiac troponin is regarded as a risk factor of cardiac event. Recently, mild elevation of cardiac troponin is reported to be associated with poor prognosis in other critically ill patients also. However, the predictors of cardiac event in such group are not determined conclusively. Method: Patients with chest pain without ST elevation underwent serial sampling of cardiac troponin I (Dimension RxL, Dade Behring Inc, Newark, DE), while they were at ER or on admission. Patients with peak troponin I level greater than low limit of detectability (0.04ng/ml) but less than suggested diagnostic value of MI (0.6ng/ml) were included. Underlying diseases and myocardial ischemia were investigated. Cardiac event during the follow-up and its predictors were evaluated. Results: Study group was consisted of Ninty patients (60짹17 years old, men:41). Conditions associated with elevated troponins were chronic renal failure (CRF, 29%), coronary artery disease (28%), dilated cardiomyopathy (16%), critically ill patients with unstable vital sign (10%), diastolic heart failure with/without hypertrophic cardiomyopathy (8%), chronic liver disease with/without GI bleeding (7%), RV failure with COPD or intracardiac shunt (3%), stroke (3%), drug intoxication (2%). During the follow-up (5.0짹3.7 months), 16 patients (18%) died and 1 patient had underwent coronary bypass. CRF, troponin I (���0.1ng/ml), CRP (���6mg/L) were predictive of cardiac event in single-variate analysis, whereas CRP was revealed to be an independent risk factor of cardiac event in multi-variate analysis (8% vs. 28%, odds ratio:5.7, p=0.042). Conclusion: Mild elevation of troponin I can have a complex clinical picture other than acute coronary syndrome. CRP could be used as an useful predictor of prognosis in patients with this condition.