To observe the apoptosis rate of peripheral blood macrophages and the polarization level of macrophages M1/M2 in patients with normal coronary artery and patients with different types of coronary heart disease, and explore their significance. Methods Patients with stable angina (SA group), patients with unstable angina (UA group), patients with acute myocardial infarction (AMI group) and subjects with normal coronary artery (control group) were included, 40 cases for each group. General clinical data of all research subjects were collected, including gender, age, height, weight, body mass index (BMI), and alanine aminotransferase (ALT), serum creatinine (Scr), creatine kinase isoenzyme (CKMB), high-sensitivity troponin I (hs-TnI) within 48 hours after enrollment, and ejection fraction (EF) value from cardiac color Doppler ultrasound before discharge. Peripheral blood samples were collected from patients within 48 h after enrollment, and macrophages were isolated and cultured. Apoptosis rate of macrophages, proportion and ratio of M1 and M2 macrophages were detected, and the relationship between them and different types of coronary heart disease were analyzed. Logistic regression was used to analyze the effects of macrophage apoptosis rate and M1/M2 ratio on coronary heart disease and UA. Receiver operating characteristic (ROC) curve was used to analyze the apoptosis rate of macrophages, M1/M2 ratio and the predictive value of their combined application on coronary heart disease and UA. Results There were no significant differences in gender, age, height, body mass, BMI, ALT and Scr between the 4 groups. Compared with the control group, the SA group and the UA group, hs-TnI and CK-MB increased and EF decreased in the AMI group (P<0.01). There were no significant differences in hs-TnI and CK-MB between the control group, the SA group and the UA group. There was no significant difference in EF between the UA group and the SA group, but which was lower than that of the control group (P< 0.01). The apoptosis rate of macrophages, the proportion of M1-type macrophages and the ratio of M1/M2 increased in the control group, the SA group, the UA group and the AMI group successively (P<0.01). Logistic regression results showed that the increased M1/M2 ratio and apoptosis rate of macrophages were risk factors for coronary heart disease and UA. ROC analysis showed that the M1/M2 ratio and apoptosis rate of macrophages had certain diagnostic value for coronary heart disease, and the combined application had higher diagnostic value (AUC were 0.835, 0.898 and 0.926). The M1/M2 ratio and apoptosis rate had certain diagnostic value for UA, and the combined application had higher diagnostic value (AUC were 0.807, 0.796, 0.862). Conclusion The apoptosis rate of macrophages and M1/M2 ratio of macrophages are closely correlated with coronary heart disease and UA, and have certain predictive value. [ABSTRACT FROM AUTHOR]