Atherosclerosis in the carotid arteries can determine a poor prognosis in individuals after the occurrence of acute coronary syndrome (ACS). Thus, we sought to assess mortality associated with carotid intima-media thickness (CIMT) in participants in the Acute Coronary Syndrome Registry Strategy (ACSR) study. CIMT was assessed by B-mode ultrasound to evaluate the risk of mortality at 180 days, 1, 2 and 3 years.We evaluated all-cause mortality, cardiovascular disease (CVD) and coronary artery disease (CAD) by tertiles of CIMT in crude, age- and sex-adjusted and multivariate-adjusted models. It also analyzed groups stratified by age (<65 years and 65 years). EMIC was mainly influenced by ageing and was not a good predictor of all-cause mortality, CVD or CAD in the ERICO study.