Abstract: AIM To investigate the significance and association of angiopoietin-like protein 2 (ANGPTL2) in acute coronary syndrome (ACS) patients. METHODSOne hundred and twenty-one subjects were recruited and were divided into ACS group ［n=88 patients, including 48 patients with ST-segment elevation myocardial infarction (STEMI) and 40 patients with non-ST elevation acute coronary syndrome (NSTE-ACS)］ and stable angina pectoris (SAP) group (n=33). Peripheral blood plasma was collected and enzyme-linked immunosorbent assay was used to test the concentration of ANGPTL2. Aspiration was used to obtain coronary thrombus in STEMI patients and ANGPTL2 expression was detected by SABC immunohistochemical method. RESULTSPlasma ANGPTL2 levels in ACS patients were significantly higher than in SAP patients (P<0.01). Plasma ANGPTL2 levels in patients with STEMI were significantly higher than those in patients with NSTE-ACS (P<0.01). Multivariate analysis showed that ANGPTL2 was an independent risk factor of ACS. In addition, ANGPTL2 was highly expressed in coronary thrombus. CONCLUSIONHigh expression of ANGPTL2 in ACS patients is an independently associated factor and may have a close relationship with platelet thrombus.