Aim To assess the predictive value of carotid atherosclerosis(CAs) on short-term outcomes in patients with premature coronary heart disease(PCHD). Methods The present study enrolled 132 patients with PCHD for percutaneous coronary intervention(PCI).The carotid artery IMT and plaques of the common carotid artery were measured by B-mode ultrasonography and their predictive value on mean 2-year outcomes of cardiac death,nonfatal myocardial infarction(MI) and recurrent angina for rehospitalization was evaluated.Results 73 patients(55%) had carotid IMT≥0.8 mm and/or plaques.72 cases with CAs and 56 without CAs were followed up for 20±8 months.There were 0,2,and 12 cases occurred cardiac death,nonfatal MI and recurrent angina for readmission respectively in PCHD patients with CAs,and it was 0,1,and 3 in patients without CAs(19.4% vs 7.1%,p<0.05).Multivariate logistic regression revealed that CAs was an independent predictor for major adverse cardiac events in PCHD after PCI(Or=5.22,95%CI: 1.34～10.25,P=0.005).Conclusions Patients of PCHD with concomitant CAs who underwent PCI had a greater incidences of mean 2-year major adverse cardiac events than those without CAs.