Objective To investigate the correlation of serum growth differentiation factor-15(GDF-15)with coronary slow flow phenomenon(CSFP)and coronary atherosclerosis(AS).Meth-ods A total of 190 patients undergoing first-time coronary angiography in our hospital from January 2019 to June 2022 were recruited,and then according to definite diagnosis,divided into CSFP group(n=60),AS group(n=70)and NC group(normal coronary flow,n=60).Their gen-eral data,risk factors for coronary heart disease,clinical biochemical indexes and electrocardio-gram were collected.The serum GDF15 level was measured by ELISA.Results Age(OR=1.065,95％CI:1.014-1.119,P=0.021),smoking history(OR=0.330,95％CI:0.132-0.823,P=0.001)and GDF-15(OR=1.006,95％CI:1.003-1.009,P=0.018)were independent influencing factors of AS.Age(OR=0.956,95％CI:0.926-0.988,P=0.024)and GDF-15(OR=1.003,95％CI:1.000-1.006,P=0.031)were independent influencing factors of CSFP.The GDF-15 level was significantly higher in the moderate or severe AS group than the CSFP group and the mild AS group(867.02±222.82 ng/L vs 568.21±163.03 ng/L and 635.41±214.95 ng/L,P＜0.01).Serum GDF-15 level was positively correlated with hs-CRP level(r=0.228,P=0.014).Conclusion GDF-15 is highly expressed in the patients with CSFP and with AS.With the increase of GDF-15 level,the severe the degree of AS gradually.GDF-15 is highly correlated with hs-CRP.