〔Abstract〕 Objective To explore the relationship between the levels of plasma lipoprotein-associated phospholipase A2(LP-PLA2), lipoprotein(a) [LP(a)] and the SYNTAX score in patients with coronary heart disease(CHD). Methods A total of 416 patients diagnosed with CHD by coronary angiography(CAG) were enrolled. According to the SYNTAX score, they were divided into three groups, 364 cases in the low-risk group(score of 0-22), 39 cases in the medium-risk group(score of 23-32), and 13 cases in the high-risk group(score of 33 or more). And another 30 cases which CAG showed no significant narrowing of the coronary arteries were selected as the control group(CON), We detected and compared the differences of the levels of LP-PLA2 and LP(a) in various groups. According to the levels of LP-PLA2 and LP(a), CHD patients were divided into four groups, 225 cases in the LP-PLA2 and LP(a) normal group, 35 cases in the only LP(a) elevated group(≥300 mg/L), 43 cases in the only LP-PLA2 elevated group(≥175 ng/ml) and 113 cases in the LP-PLA2 and LP(a) elevated group. The differences of the SYNTAX score, stenosis degree score and lesion feature score were compared. Pearson correlation and multiple linear regression were used to analyze the correlation between the levels of LP-PLA2, LP(a) and the SYNTAX score, stenosis degree score and lesion feature score. Results The levels of LP-PLA2 and LP(a) in the CHD group were significantly higher than those in the CON group(P<0.05). The levels of LP-PLA2 and LP(a) in the subgroups according to the SYNTAX score were declining from the high-risk group to the low-risk group in decending order(P<0.05). The SYNTAX score and stenosis degree score of the LP-PLA2 and LP(a) elevated group were significantly higher than those of the only LP-PLA2 elevated group, the only LP(a) elevated group, the LP-PLA2 and LP(a) normal group(P<0.05), but there was no significant difference in lesion feature score among the groups(P>0.05). Pearson correlation analysis showed that the SYNTAX score, stenosis degree score and lesion feature score were positively correlated with the levels of LP-PLA2 and LP(a)(P<0.05). The multiple linear regression showed that the SYNTAX score and stenosis degree score were independently correlated with the levels of LP-PLA2 and LP(a) after adjusting for confounding effects(P<0.05), while lesion feature score was only independently correlated with the levels of LP-PLA2(P<0.05). Conclusion The levels of LP-PLA2 and LP(a) show a positive correlation with the SYNTAX score in patients with CHD, and both can be used as indicators to determine the severity of coronary artery disease.