OBJECTIVE： To investigate therapeutic efficacy of ezetimibe combined with tirofiban in the treatment of acute coronary syndrome patients and its influence on the content of ischemia modified albumin （IMA） in peripheral blood. METHODS： A total of 82 patients with acute coronary syndrome in our hospital from Jan. 2016 to Jan. 2017 were divided into observe group and control group according to random number table， with 41 cases in each groups. All patients were given general treatment containing statins， glyceryl trinitrate and so on. Control group was additionally given Ezetimibe tablet 10 mg orally once a day. Observation group was additionally given Tirofiban hydrochloride sodium chloride injection 5 mg intravenously once a day， on the basis of control group， for consecutive 15 d. Clinical efficacies of 2 groups were evaluated. The dose of glyceryl trinitrate， duration and frequency of angina pectoris attack， left ventricular function indexes （SV， LVDD， CO， LVEF） were compared before treatment and after last medication. The contents of IMA in peripheral blood were detected before treatment and 3， 6， 9， 12， 15 h after the first day medication. ADR of the 2 groups were observed closely during the treatment. RESULTS： The total response rate of observation group was 92.7％， which was significantly higher than 72.3％ of control group （P＜0.05）. Compared with before treatment， dose of glyceryl trinitrate and the content of IMA in 2 groups were decreased significantly after last medication， duration and frequency of angina pectoris attack were shortened significantly； the levels of SV， CO and LVEF were increased significantly while the level of LVDD was decrease significantly； the effect of observation group was significantly better than that of control group， with statistical significance （P＜0.05）. No severe ADR was found in all patients during the treatment. CONCLUSIONS： Based on general treatment of glyceryl trinitrate therapeutic efficacy of ezetimibe combined with tirofiban is better than that of ezetimibe alone in the treatment acute coronary syndrome patients， and can decrease the content of IMA in peripheral blood more quickly.