After adjusting for age, sex, ACS diagnosis, coexisting conditions (hypertension, diabetes mellitus, dyslipidemia, tobacco use) and clinical markers (TC, TG, NT-pro-BNP, cTNI, and CK-MB), the multivariate analysis revealed that NLR, SII, and DD showed no prognostic values (all p > 0.05) and serum miR-186-5p may be considered an independent prognostic factor for the occurrence of one-year MACE in ACS patients after PCI (HR = 1.13, 95% CI, 1.03∼1.24, p = 0.008). This evidence concerns the gene NPPB and Hypertension.