Abstract: AIM:To study the relationship between the global registry of acute coronary events (GRACE) risk score and level of brain natriuretic peptide (BNP) and to evaluate the value of BNP in predicting major adverse cardiac event (MACE). METHODS: A total of 194 non-ST-segment elevated acute coronary syndrome (NSTE-ACS) patients admitted to our hospital between December 2011 and February 2013 were studied, including 90 patients with unstable angina (UA) and 104 patients with non-ST segment elevated myocardial infarction (NSTEMI). Plasma levels of BNP and blood lipid were measured in all patients and GRACE risk scores were used for risk assessment. Patients were followed-up for 6 months and the incidences of new or recurrent myocardial infarction, target vessel revascularization, cardiac death, and heart failure were recorded. RESULTS: According to the GRACE risk score, 59 were low-risk patients, 65 middle-risk patients and 70 high-risk patients. Plasma BNP of patients in the high-risk group was significantly higher than in the middle- and low-risk groups (P<0.05). In addition, BNP was positively correlated with the GRACE risk score (r=0.656, P<0.05). Along with the higher GRACE risk score, plasma BNP increased as well as the incidence of MACE during hospitalization or the 6-month follow-up. CONCLUSION: Plasma BNP level parallels the GRACE risk score. Both the GRACE risk score and the plasma BNP level are valuable parameters for risk stratification in NSTE-ACS patients in early stages. Increased BNP level and higher GRACE score are also predictors for increased short-term risk of MACE.