Abstract: AIM:To evaluate uricolysis of gut in patients with coronary heart disease (CHD) and to discuss the underlying mechanisms for the disturbance of uric acid from the perspective of the gut. METHODS: A total of 70 subjects provided informed consent and were recruited into the study. Forty subjects were normal and 30 were subjects with established CHD (15 with elevated serum uric acid and 15 with normal level of serum uric acid). Enzyme colorimetric method was used to detect uric acid in feces, and routine laboratory indicators were recorded. All data were analyzed by SPSS v.13.0. RESULTS: Metabolized uric acid by flora in 1 g feces of patients with CHD with normal levels of serum uric acid was significantly higher than in normal subjects (P<0.05), and metabolized uric acid of patients with CHD with elevated serum uric acid was comparable to that of normal subjects. No statistical difference was seen between CHD subgroups. Triglycerides of patients with CHD were significantly higher and high-density lipoprotein cholesterol was lower than in normal subjects (P<0.05, P<0.01). Total serum bilirubin of patients with CHD was significantly lower than normal subjects (P<0.05). CONCLUSIONS: Uricolysis of gut in subjects with CHD is significantly higher than in normal subjects. The gut may partially contribute to the abnormal metabolism of uric acid in the pathogenesis of CHD. Anti-oxidative ability of patients with CHD is lower than in normal subjects.