Objective To explore the relationship between serum heme oxygenase-1(HO-1),CD39 levels and cardiac function and major adverse cardiovascular events(MACE)in patients with successful cardiopulmo-nary resuscitation.Methods A total of 160 patients admitted to the Zigong First People's Hospital from De-cember 2019 to December 2022 who underwent successful cardiopulmonary resuscitation due to sudden heart-beat and respiratory arrest were selected as the study group.The study group was divided into cardiac function grade Ⅱ group,cardiac function grade Ⅲ group and cardiac function grade Ⅳ group using the New York Heart Association(NYHA)cardiac function grading method.In addition,100 healthy subjects who underwent physical examination in the same period were selected as the control group.The levels of serum HO-1 and CD39 in two groups were detected.After 6 months of follow-up,there were 91 cases in non-MACE group and 69 cases in MACE group.The predictive value of serum HO-1 and CD39 levels for MACE in patients with successful cardiopulmonary resuscitation was evaluated by receiver operating characteristic curve.Binary Lo-gistic stepwise regression analysis was used to investigate the influencing factors of MACE in patients with successful cardiopulmonary resuscitation.Results The serum levels of HO-1 and CD39 in the study group were higher than those in the control group,and the difference was statistically significant(P＜0.05).The levels of serum HO-1 and CD39 in cardiac function grade Ⅳ group were higher than those in cardiac function grade Ⅲ group and cardiac function grade Ⅱ group,and the difference was statistically significant(P＜0.05).Spearman correlation analysis showed that serum HO-1 and CD39 levels were positively correlated with NY-HA cardiac function classification in patients with successful cardiopulmonary resuscitation(r=0.534,0.496,P＜0.001).The serum levels of HO-1 and CD39 in MACE group were higher than those in non-MACE group,and the difference was statistically significant(P＜0.05).The area under the curve(AUC)of serum HO-1 and CD39 to predict MACE in patients with successful CPR were 0.725(95％CI:0.682-0.774)and 0.864(95％CI:0.814-0.917),respectively,and the AUC of the combined prediction was 0.901(95％CI:0.851-0.946).The time from cardiac arrest to resuscitation in non-MACE group was lower than that in MACE group,and the left ventricular ejection fraction(LVEF)was higher than that in MACE group,the difference was statistically significant(P＜0.05).Binary Logistic stepwise regression analysis showed that LVEF＜50％(OR=3.466,95％CI:1.537-7.818),serum HO-1≥5.13 ng/mL(OR=3.804,95％CI:1.706-8.479)and serum CD39≥29.87％(OR=4.345,95％CI:1.852-10.192)were the risk factors for MACE in patients with successful cardiopulmonary resuscitation(P＜0.05).Conclusion Serum HO-1 and CD39 levels have high predictive value for MACE in patients with successful cardiopulmonary resuscitation.