Abstract: Objective To explore the clinical value of serum cystatin C in prediction of coronary heart disease and its severity in female patients. Methods Through the hospital electronic medical record system, totally 90 patients with coronary heart disease confirmed by coronary angiography were selected as coronary heart disease group, and 90 patients with non-coronary heart disease were selected as non-coronary heart disease group. The coronary heart disease group was divided into acute coronary syndrome group(n=58)and chronic coronary disease group(n=32)according to types of attack, and was also divided into male group and female group according to gender. According to the Gensini score, the patients in the acute coronary syndrome group were divided into high-risk group(more than 80 points, n=22), medium-risk group(50 to 80 points, n=18)and low-risk group(less than 50 points, n=18). According to the different levels of serum cystatin C in different groups, the relationship between serum cystatin C and coronary heart disease and its severity was evaluated. Results The level of cystatin C in the coronary heart disease group was significantly higher than that in the non-coronary heart disease group(P < 0.05), and the level of cystatin C in female patients with coronary heart disease was significantly higher than that in female patients(P < 0.05). In the non-coronary heart disease group, there was no significant difference in serum cystatin C between male and female patients(P > 0.05). The level of cystatin C in the acute coronary group was significantly higher - than that in the chronic coronary artery disease group(P < 0.05), and the level of cystatin C in female patients was significantly higher than that in male patients(P < 0.05). The level of cystatin C in the high-risk group based on Gensini score evaluation was significantly higher than that in the medium-risk and low-risk group(P < 0.05), and that in the medium-risk group was significantly higher than low-risk group(P < 0.05). There was a positive correlation between Gensini score and cystatin C level(P < 0.01). Conclusion Cystatin C can be used as an important indicator for prediction of the severity of coronary heart disease. At the same time, serum cystatin C level in women is higher than men, and Gensini score is positively correlated with cystatin C level.