Abstract: AIM: To investigate the association of activated coagulation factor VII (FVIIa) as well as its gene R353Q and -323 0/10 bp polymorphism with coronary heart disease (CHD) in Hui and Han populations in Ningxia. METHODS: Four hundred twenty Hui patients and 600 Han patients with angiographically confirmed CHD, and 508 Hui healthy blood donors and 604 Han healthy blood donors (control groups) were included in the study. Plasma levels of coagulation factor VII were detected using recombinant tissue factor method and the coagulation factor VII gene R353Q, and -323 0/10 bp genotypes were identified by polymerase chain reaction amplified genomic DNA method. RESULTS: Plasma FVIIa levels were significantly higher in Hui or Han patients with coronary heart disease compared with those in respective control group (P<0.01). Plasma FVIIa levels in the subgroup of acute myocardial infarction (AMI) were significantly higher than in the subgroup of unstable angina pectoris (UAP). Significant difference in FVII gene R353Q and -323 0/10 bp polymorphism was found between Hui and Han populations. Significant difference was found in the distribution of R353Q and -323 0/10 bp genotype and allelic frequencies between Hui CHD patients and their controls, and such was also the case in the distribution of -323 0/10 bp genotype and allelic frequencies between Han CHD patients and their controls (P<0.01). R353Q in AMI group was lower than in UAP group in Hui population (P<0.01), and -323 0/10 bp was also significantly lower in AMI group compared with UAP group in Han population (P<0.01). Plasma FVIIa level was significantly higher in RR genotype than in RQ and QQ genotypes in Hui population. CONCLUSION: Plasma FVIIa levels in CHD patients are significantly higher than those of healthy subjects and plasma FVIIa levels are positively correlated with the development of CHD. R353Q and -323 0/10 bp polymorphisms of the FVII gene exist in Hui and Han populations. Plasma FVIIa levels may be influenced by the R353Q polymorphism of CHD, and the Q allele may be a protective factor against myocardial infarction in Hui population. Polymorphism -323 0/10 bp may be associated with CHD in Han population.