Aims: We investigated, in a 6 year follow-up study, whether circulating levels of C-reactive protein(CRP) and macrophage colony stimulating factor(MCSF) have an independent or complementary prognostic value in patients with chronic coronary artery disease(CAD). Methods and results: MCSF and CRP were measured in 100 patients with chronic CAD. Of 95(33% ) patients who completed the 6 year follow-up, 31 presented adverse events(death, myocardial infarction, and unstable angina). In multivariable analysis(including traditional risk factors and medications), the upper tertiles of MCSF(≥ 814 pg/mL) and CRP(≥ 2.5 mg/L) levels were independently associated with a 13- and 6-fold increase in risk of events, respectively(P< 0.01). Patients with combined high CRP and MCSF had a higher absolute risk of events than patients with elevated MCSF or CRP alone(75 vs. 59 vs. 32% , respectively, P< 0.01). The mean event-free time was 39, 64, and 52 months in patients with elevated MCSF, elevated CRP, and their combination, respectively. Conclusion: In patients with chronic CAD, the prognostic value of MCSF is independent and complementary to that of CRP.MCSF is a particularly useful prognostic marker when CRP levels are low, but also provides additional information concerning risk and time-course of events in patients with elevated CRP. Aims: We investigated, in a 6-year follow-up study, whether circulating levels of C-reactive protein (CRP) and macrophage colony stimulating factor (MCSF) have an independent or complementary prognostic value in patients with chronic coronary artery disease (CAD) Of 95 (33%) patients who completed the 6 year follow-up, 31 presented adverse events (death, myocardial infarction, and unstable angina). In multivariable analysis (including traditional risk factors and medications), the upper tertiles of MCSF (≥ 814 pg / mL) and CRP (≥ 2.5 mg / L) were were associated with a 13- and 6-fold increase in risk of events, respectively (P <0.01). Patients with combined high CRP and MCSF had a higher absolute risk of events than patients with elevated MCSF or CRP alone (75 vs. 59 vs. 32%, respectively, P <0.01). time was 39, 64, and 52 months in patients with elevated MCSF, elevated CRP, a nd their combination, respectively. Conclusion: In patients with chronic CAD, the prognostic value of MCSF is independent and complementary to that of CRP.MCSF is a particularly useful prognostic marker when CRP levels are low, but also provides additional information concerning risk and time -course of events in patients with elevated CRP.