Objective: To explore the application value of combining triple rule-out enhanced CTA with serum cardiac function indicators on predicting major adverse cardiovascular events (MACE) in emergency patients with non-traumatic chest pain. Methods: The clinical data of 160 patients with non-traumatic chest pain were retrospectively analyzed. According to whether MACE occurred within 6 months of follow-up, the above patients were classified into observation group (MACE, n=43) and control group (no MACE, n=117). Serum cardiac function indicators [creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), brain natriuretic peptide (BNP), cardiac troponin I (cTnI)] and triple rule-out enhanced CTA examination results were compared between both groups. Multivariate Logistic regression analysis was performed to analyze the independent risk factors affecting MACE, and a prediction model was constructed. Results: The D-dimer level in the observation group was higher than that in the control group (P<0.05). The levels of serum CK-MB, LDH, BNP and cTnI in the observation group were higher compared to the control group (P<0.05). The overall positive rate of triple rule-out enhanced CTA and proportions of severe coronary stenosis, aortic dissection and Stanford type A dissection were higher in the observation group (P<0.05). Multivariate Logistic regression analysis suggested that BNP and CTA severe coronary stenosis were independent risk factors for MACE in emergency patients with non-traumatic chest pain (P<0.05). The risk prediction model was constructed based on the results of multivariate Logistic regression analysis, and it was found that the AUC, sensitivity and specificity of combined model were 0.856 (95%CI: 0.795~0.918), 86.03% and 77.72% respectively. Conclusion: CTA severe coronary stenosis combined with BNP can improve the accuracy of MACE risk stratification, and provide an important reference for early clinical initiation of individualized intervention and reduction of adverse events.