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Background:As an acute phase protein,α1-antitrypsin (AAT) has been extensively studied in acute coronary syndrome,but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP).The purpose of the present study was to investigate the association between AAT plasma levels and SAP.Methods:Overall,103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study.Plasma levels of AAT,high-sensitivity C-reactive protein (hsCRP),lipid profiles and other clinical parameters were assayed for all participants.The severity of coronary lesions was evaluated based on the Gensini score (GS) assessed by coronary angiography.Results:Positively correlated with the GS (r =0.564,P ＜ 0.001),the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs.125.50 ± 19.67 mg/dl,P ＜ 0.001).The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] =1.037,95％ confidence interval [CO:1.020-1.054,P ＜ 0.001) and a high GS (OR =1.087,95％ CI:1.051-1.124,P ＜ 0.001) in a multivariate logistic regression model.In the receiver operating characteristic curve analysis,plasma AAT level was found to have a larger area under the curve (AUC) for predicting a high GS (AUC =0.858,95％ CI:0.788-0.929,P ＜ 0.001) than that of hsCRP (AUC =0.665,95％ CI:0.557-0.773,P =0.006; Z =2.9363,P ＜ 0.001),with an optimal cut-off value of 137.85 mg/dl (sensitivity:94.3％,specificity:68.2％).Conclusions:Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP,suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.