Background: The level of the N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a strong predictor of mortality among patients with acute coronary syndrome and may be a strong prognostic marker in patients with chronic coronary artery disease. We investigated whether NT-proBNP can predict in-stent restenosis (ISR) in asymptomatic patients with preserved left ventricular (LV) systolic function who underwent percutaneous coronary intervention (PCI). Methods and Results: We measured serum NT-proBNP level in 249 asymptomatic patients (61.4짹8.8 years, male 72.7%) with preserved LV systolic function (ejection fraction ��� 50 %) who underwent follow-up coronary angiography. The initial diagnosis of patients are stable angina 50 (20.1 %), unstable angina 133 (53.4 %), and myocardial infarction 66 (26.5 %). The baseline characteristics between the groups with ISR (n=92) and without ISR (n=157) are similiar. The level of NT-proBNP was higher in patients with ISR than in that without ISR (221.5짹326.8 vs. 93.9짹136.1 pg/mL, p=0.001). In ISR group, NT-proBNP level was higher in patients with previous myocardial infarction (n=27, 326.9짹401.5 pg/mL) than in that with stable angina (n=16, 213.5짹405.9 pg/mL) or unstable angina (n=49, 166.1짹232.9 pg/mL). At the standard cutpoint of > 200 pg/mL, elevated NT-proBNP level shows high probability of ISR (odd ratio, 3.24; 95% CI, 1.0 to 10.4; p =0.048). Conclusion: NT-proBNP could be a predictor of ISR in asymptomatic patients with preserved LV systolic function.