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Background: Studies have suggested that nitrated apolipoprotein A1 (NT-apoA1) levels may be associated with coronary artery disease (CAD). We therefore hypothesized that NT-apoA1 might be associated with the prediction of all-cause mortality in CAD patients. Methods: Using an ELISA, we measured plasma NT-apoA1 levels in 236 patients with known or suspected coronary artery disease (CAD) undergoing coronary angiography. The patients were then followed prospectively for the development of all-cause mortality for up to 7 years. Results: Lower NT-apoA1 levels were associated with worse renal function, lower HDL levels, higher triglyceride levels and lower ejection fraction. There was positive correlation between NT-apoA1 and HDL cholesterol levels (correlation coefficient 0.366; p <0.0001). After adjustment for a variety of baseline clinical, angiographic and laboratory parameters, log plasma NT-ApoA1 levels were an independent predictor of all-cause mortality [HR, 0.279; 95% CI, 0.084-0.922; p=0.036]. Furthermore, all-cause mortality was lower in patients whose plasma NT-ApoA1 levels were greater than or equal to the median value of the cohort compared to those whose levels were lower than median value (25.88% vs 8.82%; p = 0.001 by log-rank test). Conclusions: Higher NT-apoA1 levels are significantly associated with lower all-cause mortality in CAD patients, which may relate to HDL cholesterol function. Further studies are warranted to investigate this paradoxical finding.