Objective To explore the relationship between serum thrombospondin-1(TSP-1),cathepsin S(Cat S),and Visfatin in patients with acute myocardial infarction(AMI)and myocardial microcirculation dis-orders after PCI and their clinical prognostic value.Methods A total of 90 AMI patients who underwent PCI treatment in the hospital from June 2021 to June 2023 were enrolled in the study.They were grouped into a microcirculation disorder group(62 cases)and a normal group(28 cases)based on their myocardial microcir-culation status.According to their postoperative prognosis,they were grouped into a good prognosis group(50 cases)and a poor prognosis group(40 cases).The risk factors of poor prognosis were analyzed by Logistic re-gression,and the predictive value of serum TSP-1,Cat S and Visfatin was analyzed by receiver operating char-acteristic(ROC)curve.Results The serum levels of TSP-1,Cat S,and Visfatin in the microcirculation disor-ders group were higher than those in the normal group,and those in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P＜0.05).Elevated levels of serum TSP-1,Cat S,and Visfatin were risk factors for poor prognosis in AMI patients after PCI(P＜0.05).The efficacy of combined detection of serum TSP-1,Cat S,and Visfatin levels for predicting the prog-nosis of AMI patients after PCI was higher than that of single detection(Zcombinedprediction-TSP-1=2.245,P=0.025,Z combined prediction-Cat S=2.101,P=0.036,Z combined prediction-Visfatin=2.252,P=0.024).Conclusion The serum levels of TSP-1,Cat S and Visfatin are obviously increased in AMI patients with myocardial microcirculation disorders after PCI,and the combination of the three has relatively high efficacy in predicting the prognosis of AMI pa-tients after PCI.