Abstract: AIM To analyze the clinical characteristics and risk factors in young patients with early-onset coronary heart disease( CHD). METHODS According to the inclusion and exclusion criteria,enrolled in this study were 199 patients 40 years of age and diagnosed with coronary artery disease,1 737 patients≥65 years with CHD and 204 individuals < 40 years as normal controls. Retrospective clinical data were analyzed and compared among the three groups including age,body mass index,blood pressure,heart rate,smoking,family history,hypertension,diabetes,hyperlipidemia,cerebral vascular disease and renal insufficiency. RESULTS Coronary angiography showed that young patients mainly presented with anterior descending coronary artery lesion,single-vessel disease and acute occlusion. The ratio of male patients,smoking history,family history,hypertension and diabetes mellitus in young CHD group was higher than in the control group,and the ratio of hypertension,diabetes and hyperlipidemia in elderly patients was higher. Multiple logistic correlation analysis showed that smoking,family history,diabetes and hyperlipidemia were independent risk factors in young CHD patients,whereas alcohol consumption had some preventive effect on CHD. CONCLUSION Smoking,positive family history of CHD,diabetes and hyperlipidemia are major risk factors in young patients with early-onset CHD.