Macrophages, cytokines, and matrix metalloproteinases (MMP) play important roles in atherogenesis. The Ca2+-binding protein S100A12 regulates monocyte migration and may contribute to atherosclerosis by inducing proinflammatory cytokines in macrophages. We found significantly higher S100A12 levels in sera from patients with coronary artery disease than controls and levels correlated positively with C-reactive protein. S100A12 was released into the coronary circulation from ruptured plaque in acute coronary syndrome, and after mechanical disruption by percutaneous coronary intervention in stable coronary artery disease. In contrast to earlier studies, S100A12 did not stimulate proinflammatory cytokine production by human monocytes or macrophages. Similarly, no induction of MMP genes was found in macrophages stimulated with S100A12. Because S100A12 binds Zn2+, we studied some functional aspects that could modulate atherogenesis. S100A12 formed a hexamer in the presence of Zn2+; a novel Ab was generated that specifically recognized this complex. By chelating Zn2+, S100A12 significantly inhibited MMP-2, MMP-9, and MMP-3, and the Zn2+-induced S100A12 complex colocalized with these in foam cells in human atheroma. S100A12 may represent a new marker of this disease and may protect advanced atherosclerotic lesions from rupture by inhibiting excessive MMP-2 and MMP-9 activities by sequestering Zn2+.