Objective:To investigate the association of serum levels of tumor necrosis factor receptor-related factor 6(TRAF6)and histone deacetylase 3(HDAC3)with severity of coronary artery disease and prognosis in patients with acute myocardial infarction(AMI).Methods:A total of 122 AMI patients admitted Macheng Traditional Chinese Medicine Hospital between July 2019 and December 2020 were selected,divided into low score group(n=73,<20 points)and high score group(n=49,≥20 points)according to Gensini score.Association of serum levels of TRAF6 and HDAC3 with Gensini score was analyzed by Pearson method.According to survival condition during hospitalization within 28d,they were divided into survival group(n=85)and death group(n=37).Cox regression model was used to analyze the influencing factors for death within 28d in AMI patients;receiver operating charac-teristic(ROC)curve was used to analyze the predictive efficacy of TRAF6 and HDAC3 for death within 28d in AMI patients.Results:Patients in high score group had significant higher serum levels of TRAF6[(6.01±2.39)μg/ml vs.(5.06±1.74)μg/ml,P=0.012]and HDAC3[(4.14±1.94)ng/ml vs.(2.87±1.37)ng/ml,P<0.001]compared with low score group.Pearson correlation analysis indicated that serum levels of TRAF6 and HDAC3 were positively correlated with Gensini score(r=0.879,0.837,P<0.001 all).Patients in death group had significant higher serum levels of TRAF6[(6.89±1.67)μg/ml vs.(4.81±1.24)μg/ml,P<0.001]and HDAC3[(5.37±1.77)ng/ml vs.(2.52±0.76)ng/ml,P<0.001]compared with those in survival group.Cox regression analysis indicated that Gensini score[HR=1.857,95%CI 1.259~2.737,P=0.001],TRAF6[HR=1.659,95%CI 1.083~2.543,P=0.022],HDAC3[HR=1.779,95%CI 1.192~2.653,P=0.004]were independent risk factors for death within 28d in AMI patients.ROC curve analysis indicated that AUC of TRAF6,HDAC3 and their combina-tion predicting death within 28d in AMI patients was 0.862,0.859 and 0.971 respectively,and AUC of combination was significantly higher than those of TRAF6 and HDAC3 alone(Z=2.535,2.032,P=0.011,0.042).Conclu-sion:Serum levels of TRAF6 and HDAC3 are closely related to severity of coronary artery disease and prognosis in AMI patients,and dual combination possesses good predictive value for prognosis in AMI patients.