Abstract: Objective To investigate the correlation of serum growth differentiation factor-15 (GDF-15) and atherosclerotic progression of non-culprit coronary lesions in patients with acute coronary syndrome (ACS). Methods Total of 300 ACS patients who underwent coronary angiography in Chinese PLA General Hospital from January 2015 to October 2017 were selected in our study. Serum GDF-15 and 1-year follow-up coronary angiography were assessed. Results In this study, 17 patients were lost to follow-up with the dropout rate of 8.50%, and totally 183 ACS patients were included. Patients were divided into plaque progression group (n=59) and non-progression group (n=124) according to quantitative coronary angiography (QCA). The serum GDF-15 level was significantly higher in progression group than in non-progression group(1 227.36±193.11) mmo/L vs (1 024.90±173.84)mmo/L, P=0.037. Conclusion The level of serum GDF-15 in ACS patients is positively correlated with the progression of non-culprit coronary lesions, and it may be a potential biomarker for predicting the progression of non-culprit coronary lesions.