Background Increasing evidence suggests that prostate-specific antigen kallikrein (PSA) relates to the cardiovascular system. Recently, an association between PSA levels and aortic stiffness has been also reported in untreated essential hypertensive males. Elevated pulse pressure, a surrogate measure for increased proximal aortic stiffness, predisposes to myocardial infarction and atrial fibrillation. No studies, to date, have evaluated the relationship between PSA levels and the occurrence of AMI or new-onset atrial fibrillation in hypertensive male patients. Herein, we conducted a study to investigate this question. Methods This work is a retrospective, observational, study. Consecutive male patients were enrolled and divided in two groups: 58 patients with non - ST elevation myocardial infarction (NSTEMI) and 59 patients with new-onset atrial fibrillation. PSA levels gradually change with age and we prefer to use the percentage of age-specific PSA ranges (a.s. PSA) instead of the simple PSA levels. Results At multivariate analysis DM [0.263 (0.105–0.662); P=0.005], dyslipidemia [0.301 (0.105–0.863); P=0.025] and a higher percentage of a.s. PSA [0.908 (0.895–0.970); P=0.000] were significantly associated with the occurrence of NSTEMI. Conclusions The main results of this study showed that a higher percentage of a.s. PSA significantly relates with the occurrence of NSTEMI. In addition, the results of our investigation, also, demonstrate that the significant correlation between higher percentage of a.s. PSA and the occurrence of NSTEMI persisted after adjustment for traditional CAD risk factors (age, DM, dyslipidemia, and smoking). Large studies are needed to further confirm our findings and to elucidate the causes and effects.