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Objective: This aim of this study is to screen the differential molecules of kidney deficiency and blood stasis (KDBS) syndrome in coronary heart disease by high-throughput sequencing. In addition, the study aims to verify the alterations in the expression levels of miR-4685-3p and its regulated downstream, namely, C1QC, C4, and C5, using quantitative polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA), and to determine whether the complement and coagulation cascade pathway is the specific pathogenic pathway., Methods: Patients diagnosed with unstable angina pectoris with KDBS syndrome, patients with non-kidney deficiency blood stasis (NKDBS) syndrome, and a Normal group were recruited. The clinical symptoms of each group were further analyzed. Illumina's NextSeq 2000 sequencing platform and FastQC software were used for RNA sequencing and quality control. DESeq software was used for differential gene expression (DGE) analysis. qPCR and ELISA verification were performed on DGE analysis., Results: The DGE profiles of 77 miRNA and 331 mRNA were selected. The GO enrichment analysis comprised 43 biological processes, 49 cell components, and 42 molecular functions. The KEGG enrichment results included 40 KEGG pathways. The PCR results showed that, compared with the Normal group, the miR-4685-3p levels decreased in the CHD&#95;KDBS group ( P  = 0.001), and were found to be lower than those observed in the CHD&#95;NKDBS group. The downstream mRNA C1 regulated by miR-4685-3p showed an increasing trend in the CHD&#95;KDBS group, which was higher than that in the Normal group ( P  = 0.0019). The mRNA C4 and C5 in the CHD&#95;KDBS group showed an upward trend, but the difference was not statistically significant. ELISA was utilized for the detection of proteins associated with the complement and coagulation cascade pathway. It was found that the expression level of C1 was significantly upregulated in the CHD&#95;KDBS group compared with the Normal group ( P  < 0.0001), which was seen to be higher than that in the CHD&#95;NKDBS group ( P  < 0.0001). The expression levels of C4 and C5 in the CHD&#95;KDBS group were significantly lower than the Normal group, and were lower than that in the CHD&#95;NKDBS group ( P  < 0.0001)., Conclusion: The occurrence of CHD&#95;KDBS might be related to the activation of the complement and coagulation cascade pathway, which is demonstrated by the observed decrease in miR-4685-3p and the subsequent upregulation of its downstream C1QC. In addition, the expression levels of complement C4 and C5 were found to be decreased, which provided a research basis for the prevention and treatment of this disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Wang, Liu, Liu, Cheng, Mao, Chen, Hu, He, Hui, Qu, Lian, Duan, Dong, Liu and Li.)