Objective: To analyze the relationship between serum zinc a2 glycoprotein (ZAG) and monocyte chemoattractant protein-1 (MCP-1) levels in patients with premature coronary heart disease (PCAD) and their influencing factors. Methods: Collected 184 patients with coronary heart disease diagnosed by coronary angiography in our hospital from January 2017 to December 2019, including 86 patients with PCAD (PCAD group) and 98 patients with non-PCAD (NPCAD group), and then selected the same period 86 males <55 years of age and females <65 years of healthy physical examination were used as the control group. Collect baseline data of all subjects and detect fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein (LDL), triglycerides (TG), high-density lipoprotein (HDL), serum ZAG, MCP-1 Level, using Pearson correlation to analyze the correlation between ZAG, MCP-1 and blood lipids. Multivariate Logistic regression analysis of the influencing factors of PCAD. Results: PCAD group, NPCAD group history of diabetes, hypertension, family history of coronary heart disease, body mass index (BMI), FPG, TG, MCP-1 were higher than the control group, HDL, ZAG levels were lower than the control group (P< 0.05). The age, HDL and ZAG levels of the PCAD group were lower than those of the NPCAD group, and the proportion of family history of coronary heart disease and smoking history was higher than that of the NPCAD group (P<0.05). The results of Pearson correlation analysis showed that ZAG was positively correlated with HDL in PCAD patients, and MCP-1 was negatively correlated with HDL (P<0.05); multivariate logistic regression analysis showed that hypertension, smoking history, family history of coronary heart disease, HDL, TG, ZAG and MCP-1 are independent risk factors for PCAD. Conclusion: MCP-1 levels increase, ZAG, HDL levels decrease in PCAD patients. MCP-1 and ZAG are closely related to HDL and are independent risk factors for PCAD. [ABSTRACT FROM AUTHOR]