Objectives To investigate the relationship between intravascular ultrasound (IVUS) imaging characteristics and plasma hypersensitive C-reaction protein of premature coronary heart disease (CHD).

Methods Comparative study was conducted on 57 premature CHD and 57 late CHD patients whose data were intact and could be analysed, and the clinical follow-up was completed at 12 months after the procedure.

Results Comparison between premature CHD patients and late CHD patients, the ratio of lipid core measured by IVUS to plaque of coronary artery was in linear relationship with plasma hypersensitive CRP in premature CHD patients (p<0.001). we found that the former has more patients with family history of CHD, smoking, myocardial infarction, hyperlipaemia and unstable angina pectoris (all the p value <0.05), while the latter has more patients with diabetes. There was no difference between the two groups on the morphology of the lesions by coronary artery angiography. But lesion extent, cross-sectional areas surrounded by external elastic membrane, eccentricity index (EI), plaque plus medial area (MA), positive remodelling, plaque burden and the ratio of lipid core to plaque by IVUS were usually seen in the former group (all the p value <0.05). There was no difference on major adverse cardiac events (MACE) rate between the two groups at 12-month clinical follow-up. The MACE rate was 7.89% (9/114). Three and four patients suffered from TVR or TLR and two patients died. There was only 1 patient died from late stent thrombosis in the two groups (0.87%).