Monocyte chemoattractant protein-1 (MCP-1) participates in the recruitment of mononuclear cells to the vessel wall. The aim of the study was to evaluate the potential association between serum concentration of MCP-1 and risk of future cardiovascular events in patients with chronic coronary heart disease. A nested case control design was used. Baseline serum samples were taken from patients with coronary heart disease who were enrolled in a secondary prevention study. The MCP-1 levels were measured in those patients who had recurrent cardiovascular events during follow-up (n = 233) and compared with levels in age- and gender-matched controls. There were no differences in serum MCP-1 levels between cases and controls. The relative odds of a recurrent cardiovascular event for each 1 standard deviation difference in MCP-1 serum concentration (160 pg/ml) was 1.19 (95% confidence interval, 0.95-1.45). No increase in the relative odds for recurrent cardiovascular events was observed per increasing tertiles of MCP-1 concentrations. Elevated MCP-1 levels are not associated with long-term risk of cardiovascular events in patients with stable coronary disease.