Background: Coronary heart disease remains the leading cause of morbidity and mortality in the industrialized world. Clinical and laboratory studies have shown that inflammation plays a major role in the initiation, progression and destabilization of atheroma. Plasma high sensitivity C-reactive protein (hsCRP) is a marker of low grade inflammation and has been studied in a variety of cardiovascular disease. Objective: The aim of the study was to determine the influence of overweight and obesity to the hsCRP as a predictive, prognostic value of mortality. Subjects and Methods: Using data from the Korea Acute Myocardial Infarction registry (KAMIR) from Nov. 2005 to Sept. 2008, a total number of 10,974 patients were assessed and 5,647 overweight and obese patients (mean age 60.43+-12.23, male 75.2%) were included in this study (as per WHO guidelines for Asian population BMI < 18.5 Kg/m2 underweight, 18.5-22.9 Kg/m2 normal, 23-27.4 Kg/m2 overweight and > 27.5 Kg/m2 obese were considered.). These patients were divided into four groups based on hsCRP level (1st quartile < 0.2 mg/dL, n=1370; 2nd quartile ��� 0.2 to < 0.82mg/dL, n=1451; 3rd quartile ��� 0.82 to < 4.08 mg/dL, n=1413; 4th quartile ��� 4.09 mg/dL, n=1413). Twelve –month all cause death was evaluated. Results: Overweight and obese patients with higher hsCRP (2nd , 3rd and 4th quartiles) were older, had more incidence of hypertension, diabetes mellitus, heart failure, Killip>1 and cerebrovascular disease. Multivessel involvement (p<0.001), type C (p<0.001), preTIMI 0 (p=0.002) and post TIMI 3 (p=0.004) were observed more frequently in patients with high hsCRP. There was no significant difference of statin treatment among four groups after PCI. Mortality rate at 12 months increased as the value of hsCRP increased; 2.3% (n=27) in 1st quartile, 3.1% (n=37) in 2nd quartile, 5.5% (n=62) in 3rd quartile and 8.4% (n=94) in the 4th quartile. Twelve month mortality was higher in patients with 4th quartile compared to other patients (hazard ratio [HR] 1.865; 95% confidence interval [CI] 1.037-3.353; p=0.0037). Other independent factors for 12 month mortality were low systolic BP (<100mmHg), high heart rate (>100beats/min), Killip >1, diabetes mellitus and LVEF <55%. Conclusion: Elevated levels of hsCRP in overweight and obese subjects predict all cause mortality independent of other prognostic markers. Level of hsCRP may help guide risk stratification of high risk individuals such as those with coronary heart disease.