Abstract: AIM:To analyze the relationship between psychological factors and coronary heart disease (CHD). METHODS: Four hundred and thirty-four patients with CHD were recruited from our hospital and divided into two groups: 162 cases with anxiety and depression (Group A) and 272 cases without anxiety and depression (Group B). A comparative study of their clinical manifestations and coronary artery angiography was performed between groups. RESULTS: Higher degrees of anxiety, palpitations, fatigue, insomnia, irritability and more severe coronary artery lesions were found in Group A compared with those in Group B, with statistical difference (P<0.05). Psychological factors in patients with CHD were positively correlated with the extent and severity of CHD (P<0.01). Among the psychological factors, depression had a worse effect than anxiety in regard to coronary artery diseases. CONCLUSION: Psychological factors are associated with the severity of coronary artery lesions in patients with CHD.