Background: Brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are not specific for ventricular dysfunction. And other cardiac processes such as myocardial ischemia may also cause elevation in these markers. Methods and Results: To determine whether elevation of NT-proBNP without elevation of cardiac specific marker could predict the coronary artery disease (CAD), we measured serum NT-proBNP level in 389 unstable angina pectoris patients (59.2짹10.2 years, male 59.9 %) with normal ventricular function [left ventricular ejection fraction >55 % and no regional wall motion abnormality by echocardiography] and normal troponin I level (<0.05 ng/mL). In these patients, levels of c-reactive protein and myoglobin were normal and electrocardiographic (ECG) finding had no-Q wave. NT-proBNP level was higher in patients with CAD (n=209) than that in patients without CAD (n=180) (151.1짹212.9 vs. 64.6짹70.8 pg/mL, p<0.001). At the standard cutpoint of >200 pg/mL, elevated NT-proBNP level shows high probability of CAD (odd ratio, 4.28; 95% CI, 2.1 to 8.8, p<0.001). And NT-proBNP level was positively correlated with extent of CAD (r=0.372, p<0.001). In multivariate analysis, the NT-proBNP was independent predictor of CAD. Conclusion: This results suggested that NT-proBNP is useful screening test for CAD in patients with unstable angina pectoris and normal troponin I and ECG.