Aim To explore the relationship between fractional flow reserve (FFR) technical parameters and myocardial zymogram in patients with non-ST-segment elevation acute myocardial infarction (NSTEMI) and the predictive value of major adverse cardiovascular events (MACE). Methods A total of 136 NSTEMI patients admitted to Liaocheng Third People's Hospital from February 2017 to February 2020 were selected and all underwent percutaneous coronary intervention (PCI) under the guidance of FFR. According to whether MACE occurred 1 month after operation, all patients were divided into MACE group (n＝14) and non-MACE group (n＝122). The clinical data, myocardial enzyme spectrum indexes, quantitative coronary angiography (QCA) parameters, and FFR technical parameters were compared between the two groups. The correlation between FFR technical parameters and myocardial enzyme spectrum indexes and QCA parameters was analyzed. The Logistic regression equation was used to analyze MACE influencing factors. The receiver operating characteristic (ROC) curve and the area under curve (AUC) were used to analyze the myocardial zymogram indexes, QCA parameters, and FFR to predict the value of MACE. Results Compared with the non-MACE group, the proportion of patients aged ≥60 years old in the MACE group increased 0.55 times, the GRACE score increased 0.11 times, the cardiac troponin I (cTnI) level increased 0.38 times, the creatine kinase (CK) level increased 0.22 times, the creatine kinase isoenzyme-MB (CK-MB) level increased 0.24 times, and the stenosis degree increased 0.08 times, the lesion length increased 0.11 times, the FFR decreased 11.9%, and the minimum lumen area of criminal vessels decreased 12.8%, the difference was statistically significant (P＜0.05); FFR was negatively correlated with cTnI, CK, and CK-MB levels (P＜0.05); FFR was negatively correlated with stenosis and lesion length (P＜0.05); Logistic regression analysis showed that after adjusting for age, GRACE score, and culprit vessel minimum lumen area, myocardial zymogram indexes (cTnI, CK, CK-MB), QCA parameters (degree of stenosis, lesion length), and FFR were all related to the occurrence of MACE (P＜0.05); The AUC of MACE predicted by FFR was 0.885, the sensitivity was 92.86%, and the specificity was 65.88%. Conclusion There is a negative correlation between FFR and myocardial enzymes (cTnI, CK and CK-MB) levels in NSTEMI patients, and are related to the occurrence of MACE, which can predict the risk of MACE.