Abstract: Objective To analyze the correlation between plasma thrombomodulin(TM)level and early prognosis in patients with radial coronary artery bypass grafting. Methods According to plasma TM level within 24 h after operation, 193 patients with radial coronary artery bypass grafting were divided into low TM group(n=97)and high TM group(n=96). According to incidence of cardiovascular and cerebrovascular events within 6 months after discharge, the patients were divided into good prognosis cases(n=121)and poor prognosis cases(n=72). The level of plasma TM was detected by ELISA. The general information, operation condition, complicated diseases conditions and prognosis were analyzed in both groups. The factors influencing the early prognosis of patients with radial coronary artery bypass grafting were analyzed. Results Compared with the low TM group, a higher body mass index(BMI), a lower left ventricular ejection fraction(LVEF)and a higher ratio of cases with smoking history were found in high TM group, and differences were statistically significant(P<0.05). Compared with the low TM group, higher ratios of cases with type 2 diabetes mellitus as well as new and old myocardial infarction were found in high TM group, and differences were statistically significant(P<0.05). The good prognosis rate of the high TM group was significantly lower than that of the low TM group(P<0.05). Multivariate Logistic regression analysis showed that TM, new and old myocardial infarction were the independent risk factors for adverse prognosis of patients after radial coronary artery bypass grafting(P<0.05), and LVEF was a protective - factor for adverse prognosis after radial coronary artery bypass grafting(P<0.05). Conclusion The plasma TM level is related to the preoperative physical condition of patients. The incidence of adverse cardiovascular and cerebrovascular events in patients with high TM level is higher than that in patients with low TM level, and the change of TM level is of great significance in evaluating the prognosis of patients with coronary heart disease.