Prediction of major adverse cardiac events (MACE) has recently been a focus of biomedical researches. Identification of the predictors can be useful to select at risk patients for preventive treatment and healthy-life maintenance. The aim of this study was to evaluate the role of soluble thrombomodulin (sTM) to predict the development of MACE after PCI and stent placement. A total of 140 patients (aged 40-70 Years) undergoing percutaneous coronary intervention (PCI) and stent placement who’s had inclusion craiteria were enroled. Personal information and medical history were recorded in a form. Blood samples were collected 24 hours after PCI and serum level of sTM was measured. Patients were followed up for 18 months. Coronary angiography was done for patients with chest pain or positive results of non- invasive tests. End point of the study was MACE including death, MI, early or late stent Thrombosis, Target vessel revascularization (TVR) and target lesion revascularization (TLR). mean age of patients was 55.61 and most of them were male (65%)-most common risk factor was dislipidemia (46%) and LAD was most common vessel (69%)- in follow up time coronary angiography was done for 39 patients That 29 of Them (20.7) had MACE 13 target. Lesion restenosis, 10 target vessel restenosis, 2 MI and 3 Thrombosis and one patient dead. There was signification association between, Reference vessels diameter with MACE (2.56 ± 0.25 VS 3.28 ± 0.39 mm P< 0/001). Mean Blood level of sTM in patients who had MACE was lower than mean sTM in other patient but there was not statistically significant (13.99 ±2.65 VS 15.11 ±3.25 ng/ml P=0.070). But among patients who had not current risk factors, mean blood level of sTM in cases with MACE was significantly lower than mean of sTM in cases without MACE.(11.84 ± 1.92 VS 16.46 ± 3.38 ng/ml P= 0.019 ) but only 4 patients were in first group ( patients without current risk factors who had MACE). Despite the result of our study indicate that in patients who had not current risk. Factors, development of MACE after PCI and stent placement associate with low blood level of sTM but introduce of sTM as a predictor, need to supplementary investigations with more number of the patients.