Backgrounds : Soluble receptor for advanced glycation end products (sRAGE) and endogenous soluble RAGE (esRAGE) have been known to be associated with vascular inflammation. We investigated the relationship between s/es RAGE level and plaque vulnerability in patients with acute myocardial infarction (AMI). Methods : We enrolled sixty patients with AMI (30 men, mean age 63 짹 12.6), who performed primary percutaneous coronary intervention within 12 hours after the onset of chest pain, and age- and sex-matched controls with normal coronary angiography. Immediately before performing coronary angiography, blood samples were obtained and then the plasma levels of sRAGE and esRAGE were measured by Enzyme-linked immunosorbent assay . Results : There were no significant differences in baseline characteristics between two groups except for the higher plasma level of high-sensitive CRP in patients with AMI (2.64 짹 3.07 vs. 1.05 짹 4.15, p=0.035, respectively). The plasma levels of matrix metalloproteinase-9 (MMP-9) and sRAGE were higher in patients with AMI (MMP-9: 26.1 짹 22.1 vs. 18.4 짹 15.29, p=0.03; sRAGE: 872.7 짹 607.17 vs. 562.2 짹 507.9, p=0.047, respectively). But there was no statistical difference in esRAGE (0.34 짹 0.296 vs. 0,33 짹 0.323, p=0.941, respectively). In multiple logistic regression analysis, the elevated plasma levels of sRAGE (odds ratio (OR) 1.010, 95% confidence interval (CI) 1.001-1.037, p=0.011) and MMP-9 (OR 1.044, CI 1.013-1.075, p=0.004) were independent risk factors of AMI. Conclusions : The elevated plasma level of sRAGE is independently associated with plaque vulnerability in patients with AMI like MMP-9.