Objective To investigate the predictive value of adductor 3(ADD3)and matrix metalloprotein-ase 14(MMP14)in peripheral blood of patients with acute ST segment elevation myocardial infarction(STE-MI)for acute heart failure(AHF).Methods A total of 98 STEMI patients admitted to the inpatient depart-ment of the Department of Cardiology of the hospital from November 2019 to October 2022 were selected as the STEMI group.STEMI patients were divided into AHF group(30 cases)and non AHF group(68 cases)according to whether AHF occurred within 48 hours of onset,and 63 healthy volunteers who urderwent the physical examination in the hospital were selected as control group.The levels of ADD3 and MMP14 in pe-ripheral blood was detected,and their relationship with AHF in STEMI patients and the value in predicting AHF were analyzed.Results The level of ADD3 in peripheral blood in STEMI group was lower than that in the control group(P＜0.05),and MMP14 level was higher than that in the control group(P＜0.05).The level of ADD3 in peripheral blood in AHF group was lower than that in non AHF group(P＜0.05),and the level of MMP14 was higher than that in non AHF group(P＜0.05).The level of ADD3 in peripheral blood of STEMI patients was negatively correlated with cardiac troponin Ⅰ(cTnI),creatine kinase isoenzyme(CK-MB),brain natriuretic peptide(BNP),and Killip grading(P＜0.05),and the level of MMP14 was positively correlated with cTnI,CK-MB,BNP,and Killip grading(P＜0.05).Killip grade Ⅳ,high BNP level and high MMP14 level were risk factors for complications of AHF in STEMI patients(P＜0.05),and high ADD3 level was a protective factor(P＜0.05).The area under the curve of the combination of ADD3,MMP14 and BNP for predicting AHF in STEMI patients was 0.890,which was greater than 0.704,0.702,0.750 of individual indicators alone(P＜0.05).Conclusion ADD3 level in peripheral blood of STEMI patients is decreased and MMP14 level is increased,which is associated with complication of AHF.ADD3 and MMP14 are expected to be biological indicators of AHF in STEMI patients.