Objective To explore whether creatinine could add relevant prognostic value of Banach risk score for 30-day mortality in suspected cardiac chest pain patients presented to Emergency Department(ED). Methods A perspective cohort study was conducted in ED from March 17, 2012 to August 14, 2013. Chest pain patients presented to ED with age over 18 years old were enrolled. Clinical data and items of Banach risk scores were remarked. The 30-day mortality of patients was followed up through Health Insurance Information Management System and phone. Results A total of 514 suspected cardiac chest pain patients were enrolled, 238(47%)of them were diagnosed as ischemic cardiac chest pain. Non-ischemic cardiac aetiologies and non-cardiac aetiologies were 135 cases(26%)and 141 cases(27%), respectively. Thirty patients(6%)die within 30 days. The areas under the curve(AUC)for 30-day mortality of Banach score was 0.789(95% CI 0.751～0.825)in cutoff with 3 points. The AUC of modified Banach score consisting of creatinine involvement was 0.826(95% CI 0.790～0.829)in cutoff with 5 points. There was significant differences between two scores, P=0.006, Z-statistics=2.771.  Conclusion Creatinine can improve the prognostic value of Banach risk score for 30-day mortality in suspected cardiac chest pain patients presented to ED.