Abstract: Objective To investigate the correlation between pregnancy-related plasma protein A level and the pathogenesis of acute coronary syndrome (ACS). Methods Sixty patients with ACS in our hospital from February, 2013 to May, 2014 were enrolled in this study. Among them, 28 cases were with variant angina (UAP), 32 patients with acute myocardial infarction (AMI). Another 30 patients with stable angina pectoris (SAP) were selected as the SAP group and 30 healthy individuals as the healthy control group. The general information on the sex, age and vital signs of selected cases were recorded. On the first day after admission, fasting venous blood was collected for NTT, blood test, serum uric acid, CK-MB, hs-CRP, blood lipids and other tests. Blood samples were collected for pregnancy-related plasma protein A (PAPP-A) test. The differences of the levels of each index in each group were compared, and the correlation between pregnancy-related plasma protein A and high-sensitivity C-reactive protein was evaluated. Results There were no significant difference in the age, gender, BMI and other indicators between the three groups. PAPP-A was significantly different between those acute coronary syndrome groups and healthy control group (P<0.01). The serological indexes of each group were compared, the results showed that the overall differences were statistically significant (P<0.05), and there was significant difference between each group and the control group; and the correlation between PAPP-A and hs-CRP Sex was statistically significant (r=0.978, P<0.001). Conclusion The incidence of ACS and pregnancy-related plasma protein A has a positive correlation, the higher the concentration of PAPP-A, the greater the risk of acute coronary syndrome.