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The prevalence and potential role of autoantibodies against the β1-adrenoceptor autoantibody (β1-aab) and cardiac troponin-I (anti-cTnI) in patients with ST-elevation myocardial infarction (STEMI) are unknown. The aim of this study is to test whether β1-aab and anti-cTnI are prevalent in STEMI patients and to investigate their prognostic value for left ventricular remodeling and clinical outcomes in STEMI patients.This study included 491 patients with first STEMI at two centers. Serum samples were obtained. β1-aab and anti-cTnI were detected by enzyme-linked immunoabsorbent assay. Echocardiographic assessments were performed at admission and following 1 year. The major adverse cardiovascular events (MACEs) were evaluated during a median follow-up period of 37 months.The positive rates of β1-aab and anti-cTnI in STEMI patients were 39.1 and 19.1%, respectively. The extent of left ventricular remodeling correlated with the presence of β1-aab and/or anti-cTnI (double positive > single positive > double negative). Logistic regression revealed that both β1-aab [odds ratio (OR) 2.298, 95% confidence interval (CI) 1.561–3.384, P < 0.001] and anti-cTnI (OR 2.389, 95% CI 1.460–3.909, P = 0.001) were predictive of left ventricular remodeling. Cox proportional-hazard regression revealed that β1-aab, but not anti-cTnI, was strongly predictive of MACEs (hazard ratio 1.802, 95% CI 1.301–2.496, P < 0.001).β1-aab and anti-cTnI were prevalent in STEMI patients. Both β1-aab and anti-cTnI were independent predictors of left ventricular remodeling, whereas only β1-aab was an independent predictor of MACEs. Our findings suggest that β1-aab and anti-cTnI may actively participate in the process of left ventricular remodeling after STEMI.