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Objective: To investigate the relationship between serum myeloperoxidase (MPO) level and contrast-induced acute kidney injury (CI-AKI) and prognosis in patients undergoing emergency percutaneous coronary intervention (PCI) and its predictive value.Methods: 381 patients with acute myocardial infarction who underwent emergency PCI in The Second Affiliated Hospital of Anhui Medical University from March 2020 to February 2021 were selected. The clinical data were collected and the serum MPO level was detected within 12 hours before operation. According to the occurrence of CI-AKI after operation, they were divided into CI-AKI group (n=34)and non CI-AKI group (n=347). Multivariate Logistic regression was used to analyze the influencing factors of the incidence of CI-AKI in patients undergoing emergency PCI, and receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of MPO in predicting CI-AKI. According to the best cutoff value, the patients were divided into high MPO group and low MPO group, and the patients were followed up for 12 months. The cumulative incidence of major adverse cardiovascular events (MACE) in high MPO group and low MPO group were analyzed by Kaplan-Meier survival curve. Results: The proportion of combined hypertension, diabetes mellitus, hyperlipidemia and smoking history proportion in CI-AKI group were higher than those in non CI-AKI group, and MPO level, creatinine level, contrast agent dosage were higher than those in non CI-AKI group (P＜0.05). Multivariate Logistic regression analysis showed that diabetes mellitus, high MPO and creatinine level were the risk factors influencing the occurrence of CI-AKI after emergency PCI (P＜0.05). ROC curve analysis showed that the area under the curve (AUC) of preoperative serum MPO level in predicting CI-AKI after emergency PCI was 0.726, and the optimal cut-off value was 491.12 μg/L, with a sensitivity of 58.80%, and specificity of 76.50%. A total of95 cases of MACE occurred one year after operation, with an incidence of 24.93%. Kaplan-Meier survival curve showed that the incidence of MACE in high MPO group was 27.37% higher than that in low MPO group 22.77% (P＜0.05). Conclusion: The serum MPO level of patients with CI-AKI after emergency PCI significantly increased, which is associated with the prognosis of patients, and it is a risk factor for CI-AKI, with high specificity, which can be an effective auxiliary indicator for predicting the occurrence of CI-AKI after emergency PCI. [ABSTRACT FROM AUTHOR]