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Objective: To investigate the alteration of plasma levels of omentin-1 and visfatin in elderly patients with coronary heart disease (CHD) and heart failure. Methods: Plasma omentin-1 and visfatin levels were measured in 90 subjects (29 stable angina pectoris (SAP) cases, 30 unstable angina pectoris (UAP) cases and 31 age- and sex-matched healthy controls (age 60 years) by enzyme-linked immunosorbent assay methods. According to the New York Heart Association classification, 59 CHDs were divided into three groups: functional I class, 11 cases; functional Ⅳ/ class, 36 cases; and functional IV class, 12 cases. Results: The plasma level of omentin-1 in CHD patients was significantly lower than that of the control group. Omentin-1in SAP group and UAP group were significantly lower compared to the control group (there was no statistical significance between UAP group and SAP group; P>0.05). The plasma level of visfatin in CHD patients was significantly higher than that of the control group. Similarly, visfatin in SAP group and UAP group were all significantly higher compared to the control group, while there was no statistical significance between UAP group, and SAP group. The plasma omentin-1 level was negatively correlated with SBP (r=-0.264, P<0.05), positively correlated with HDL-c level (r=0.271, P<0.05); the plasma visfatin level was positively correlated with TC (r=0.292, P<0.05), negatively correlated with HDL-c level (r=-0.266, P<0.05). There was a negative correlation between plasma omentin-1 and visfatin levels (r=-0.280, P<0.05). Moreover, multiple linear stepwise regression analysis showed that omentin-1 and visfatin levels might be affected by HDL-c level. Logistic regression analysis showed that visfatin could be an independent risk factor of CHD. Conclusions: Decreased levels of omentin-1 and increased levels of visfatin may be involved in the occurrence and development of CHD. Omentin-1 and visfatin, independently, may be protective and pro-inflammatory cytokines. Additionally, both omentin-1 and visfatin may be related to lipid metabolism. Visfatin may be an independent risk factor of CHD.