Abstract: ObjectiveTo investigate the relationship between serum bilirubin， homocysteine (Hcy) levels and carotid atherosclerotic plaque in elderly patients with coronary heart disease (CHD). MethodsA sum of 210 cases of elderly patients with coronary heart diseasefrom our hospital were  enrolled. The carotid intimamedia thickness(IMT)  were observed by the carotid artery ultrasound.According to the value of IMT，all cases were divided into two groups:plaque group (n=82) and non plaque group (n=128)， recording the patient’s age， gender， history of hypertension， history of diabetes， smoking history and other general situation， detection of serum total bilirubin， direct bilirubin， indirect bilirubin， Hcy and lipid laboratory indicators. ResultsThe total bilirubin and indirect bilirubin levels were lower in plaque group  than those of non plaque group. However， the plasma Hcy level in plaque group was higher than non plaque group (P<0.05).The total bilirubin， indirect bilirubin was negatively correlated with carotid artery plaqu  erespectively(r=-0.447，-0.482，P<0.05) and Hcy level was positively correlated with the carotid plaque(r=0.376，P<0.05).The logistic stepwise regression analysis showed that total bilirubin and indirect bilirubin levels decreased and Hcy increased were  risk factors in the progression of carotid artery plaque formation.ConclusionThe intervention of the formation of serum bilirubin and Hcy in patients with carotid atherosclerosis  might  prevent the occurrence of acute cardiovascular and cerebrovascular events in CHD patients.

Key words: coronary , disease;plaque, atherosclerotic, bilirubin;homocysteine