Objective：Observing the expression of visceral fat-specific serine protease inhibitor（Vaspin），cardiac troponin T（cTnT）and N-terminal pro-brain natriuretic peptide（NT-pro-BNP）in acute coronary syndrome（ACS），stable coronary heart disease and control to provide new basis of Vaspin for clinical diagnostic and prognostic evaluation of ACS. Methods：A total of 158 patients with ACS，80 patients with stable coronary heart disease and 90 patients without coronary heart disease were included. The expression of Vaspin was detected by enzyme-linked immunosorbent assay，while the levels of cTnT and NT-pro-BNP were detected at the same time. The expression levels of Vaspin，cTnT and NT-pro-BNP were analyzed and compared in three groups by one-way ANOVA. A 2-year follow-up of clinical outcomes including cardiac death，rehospitalization and revascularization was conducted and logistic analysis was used to evaluate the relationship between Vaspin level and clinical prognosis. Results：The results showed significant difference of Vaspin，cTnT and NT-pro-BNP among three groups（P < 0.01）. The expression level of Vaspin was lowest in ACS group and highest in control group，while the expression level of cTnT and NT-pro-BNP were highest in ACS group and lowest in control group. There was significant negative correlations between Vaspin and NT-pro-BNP or cTnT. Furthermore，lower expression level of Vaspin indicated higher risk of cardiovascular adverse events，such as cardiac death，rehospitalization and revascularization. Conclusion：The expression level of Vaspin in ACS was significantly lower than that in stable and non-coronary heart disease，which was negatively correlated with NT-pro-BNP and cTnT. Vaspin is an independent risk factor for ACS，and the lower expression level of Vaspin，the worse prognosis of patients.