Objective:To analyze the correlation between microRNA(miR)-146,apolipoprotein E(ApoE),and acute coronary syndrome(ACS).Methods:A total of 100 ACS patients admitted to the hospital from June 2020 to June 2021 were selected,including 46 cases in the mild group(Gensini score≤45 points)and 54 cases in the severe group(Gensini score>45 points).Another 50 cases with normal arte-riography were included in the control group.The serum levels of miR-146a,miR-146b,and ApoE were determined,and their correlation to ACS was studied.Results:There were significant differences in the incidence of hypertension and diabetes and blood lipids levels between the three groups(P<0.05);the levels of miR-146a,miR-146b,and ApoE,and Gensini scores were also significantly different among the three groups(P<0.05).The changes in miR-146a,miR-146b,and ApoE levels were related to the severity of the disease(P<0.05).Pearson correlation analysis showed that levels of miR-146a,miR-146b,and ApoE were positively correlated to Gensini scores(P<0.05);logistic multivariate analysis showed that hypertension,diabetes,miR-146a,miR-146b,ApoE,and Gensini scores were the risk factors for ACS(P<0.05).Conclusion:The levels of miR-146a,miR-146b,and ApoE in ACS patients are significantly increased and show correlations to the degrees of coronary artery disease,and they are the risk factors for ACS.