ObjectiveTo explore the relationship between pregnancy-associated plasma protein-A (PAPP-A) and different types of coronary heart disease (CHD) in Chinese. MethodsThe papers about the relationship between the PAPP-A level and coronary heart disease in Chinese published before December 2013 were searched from electronic databases, including PubMed, EMbase, China National Knowledge Infrastructure, Wanfang and VIP. Statistical analysis was carried out using Stata 12.0 software. ResultsA total of 44 papers were included in this meta-analysis. The number of cases was 3 628, including 1 137 stable angina pectoris (SAP) patients, 1 368 unstable angina pectoris (UAP) patients and 1 123 acute myocardial infarction (AMI) patients. The number of control was 1 177. This meta-analysis indicated that the levels of PAPP-A were higher in different types of CHD patients than those in the control group[SAP group:SMD=0.38, 95% CI (0.25, 0.50), P < 0.001; UAP group:SMD=2.84, 95% CI (2.36, 3.32), P < 0.001; AMI group:SMD=3.31, 95% CI (2.78, 3.85), P < 0.001, respectively]. The levels of PAPP-A were higher in AMI group than UAP group[SMD=0.56, 95% CI (0.33, 0.80), P < 0.001]. At the same time, the levels of PAPP-A in patients with disease of one, two and three coronary arteries were higher than those in the control group[SMD=2.40, 95% CI (1.49, 3.31), P < 0.001; SMD=2.27, 95% CI (1.44, 3.09), P < 0.001; SMD=2.30, 95% CI (1.35, 3.24), P < 0.001, respectively]. The levels of PAPP-A were higher in patients with disease of two arteries than in those of one artery[SMD=0.29, 95% CI (0.01, 0.58), P=0.042], but there was no significant difference between patients with disease of three arteries and those of 1 or 2 arteries(P > 0.05). ConclusionsThe levels of PAPP-A are significantly higher in CHD patients and are positively related with the severity of CHD. The levels of PAPP-A can be regarded as the indicator for judging the severity of CHD