Background: Biomarkers have emerged as interesting predictors of risk in ischemic heart disease patients. These predictors were associated with adverse short-term and long-term outcomes in ischemic heart disease (IHD) patients. This study aimed to analyze the predictors of major adverse cardiovascular events (MACE) in ischemic heart disease (IHD) patients. Methods: We conducted a retrospective analysis of collected data on 2525 consecutive patients who had been hospitalized with IHD between May 2006 and April 2009 at our centers. We assessed demographic (age, sex) and clinical characteristics and echocardiographic and laboratory findings. The risk for major events (death, new acute coronary syndrome (ACS), and revascularization) was analyzed. Results: The patients were divided into MACE group (55 patients, mean age 64 yr, male 30, mean follow duration 154 days) and no MACE group (2470 patients, mean age 63 yrs, male 1295, mean follow duration 428 days). There was higher incidence of diabetes in MACE group. The patients in MACE group had lower left ventricular ejection fraction (LVEF). The level of C-reactive protein, uric acid and apo-lipoprotein b/a in MACE group were significantly higher compared to those in no MACE group. The estimated glomerular filtration rate in MACE group was significantly lower compared to it in no MACE group. After adjustment for several significant parameters, using a Cox proportional hazards model, only apo-lipoprotein b/a ratio (adjusted p = 0.004; odds ratio [OR] 2.976) was identified as significant independent predictors for MACE in IHD patients. Conclusions: Apo-lipoprotein b/a ratio might be used as a predictor of MACE in IHD patients.