Objective To investigate the relationship between insulin resistance and plasminogen activator inhibitor type 1 in the elderly of coronary heart disease. Methods PAI 1, ISI, WHR, BMI, fasting glucose and insulin were meausred. Results Compared with controls, in coronary heart disease group, ISI was lower and PAI 1 was higher. PAI 1 correlated significantly with ISI and WHR. Conclusion ISR and higher PAI 1 were ween in coronary heart disease group. PAI 1 correlated with ISR.