We investigated prognostic value of cobalt-binding capacity of albumin in patients with acute coronary syndrome (ACS). An influence of this parameter on 30-days and remote prognosis is estimated. Material and methods. We enrolled 93 patients with ACS. Cobalt-binding capacity was measured in all involved patients. We divided patients into groups of favorable and poor course according to primary end point (death from cardiovascular causes, recurrent myocardial infarction, refractory angina and emergency revascularization within 30 days after ACS). Results. Cobalt-binding capacity level was significantly higher in patients with recurrent myocardial infarction (p=0.036). In patients with its level higher then 0.4U/ml hazard ratio for the recurrent myocardial infarction was 2.45 (95% CI 0.1-4.8; р=0.041). Besides it was concluded that patients with refractory angina had higher cobalt-binding capacity level (p=0.016). Conclusion. High cobalt-binding capacity level could identify patients with worse prognosis after ACS.