Objective To explore the association of Lipoprotein-associated phospholipase A2(LP-PLA2) and Antithrombin Ⅲ(AT-Ⅲ)level with the severity of coronary artery lesion in patients with coronary disease. Methods 276 patients undergoing coronary angiography were recruited in the Affiliated Hospital of Xuzhou Medical University from March,2016 to March,2017. Patients were sent to one of the two following groups according to their CAG reports:the controlled group(n=111)and the CAD group(n=165). Gensini scores were calculated in CAD group,and divided CAD group into 4 groups by quartiles:group 1(n=41),group 2(n=39),group 3 (n=42)and group 4(n=43). LP-PLA2 and AT-Ⅲwere then compared in different groups and correlation was analyzed in deciding the severity of coronary artery disease. Results (1)LP-PLA2 level in CAD group was signifi-cantly higher than the controlled group(342.9 ± 91.9 vs. 131.8 ± 27.0,P<0.05),but AT-Ⅲlevel was lower than controlled group and(91.0 ± 12.9 vs. 97.8 ± 11.0,P<0.05).(2)Both LP-PLA2 and AT-Ⅲlevel were different in groups stratified by the quartiles of Gensini scores,and the difference is statistically significant.(3)LP-PLA2 was a risk factor while AT-Ⅲwas a protectional factor for coronary artery disease(OR=1.08,95%CI:1.05~1.11,P<0.01;OR=0.95,95%CI:0.93~0.98,P<0.01;respectively )analyzed by Logisitic regression model.(4)Correla-tion analysis showed a positive association of LP-PLA2 level with Gensini scores(r=0.48,P<0.01),and a nega-tive association of AT-Ⅲlevel with Gensini scores(r=-0.24,P<0.01). Conclusion LP-PLA2 level was higher in CAD patients compared to normal patients ,while the relationship of AT-Ⅲ level among the two groups was reversed. Elevated LP-PLA2 level was associated with the increased severity of coronary artery and can provide guidance for clinic.