Objective To investigate the predictive value of serum low-density lipoprotein cholesterol（LDL-C） and high-sensitive C-reactive protein（hs-CRP） in combination with carotid ultrasound parameters for assessing the risk of coronary heart disease（CHD）in patients with suspected cases. Methods A total of 260 patients who underwent coronary angiography（CAG） in the Department of Cardiology at Wujin Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from August 2022 to August 2024 due to suspected CHD were enrolled in this study. Based on CAG results， patients were categorized into a non-CHD group（n = 110） and a CHD group（n = 150）. General clinical characteristics， serum LDL-C， hs-CRP levels， and carotid ultrasound arameters-including carotid intima-media thickness （CIMT） and Crouse score of carotid artery plaque-were compared between the two groups. Spearman correlation analysis and multivariate logistic regression analysis were conducted to evaluate the associations among these parameters. The predictive value of individual and combined markers for suspected CHD was assessed by using receiver operating characteristic（ROC） curve analysis. Results （1）The coronary heart disease（CHD） group had higher age， smoking，fasting plasma glucose（FPG）， and blood pressure compared to the non-CHD group（P > 0.05）. No significant difference was observed in the gender ratio， alcohol consumption rates， and body mass index（BMI）， between the two groups（P > 0.05）. （2） Total cholesterol（TC）， LDL-C， hs-CRP levels， and carotid ultrasound parameters were significantly higher in the CHD group than those in the non-CHD group （P < 0.05）. （3） Spearman correlation analysis and multivariate logistic regression analysis revealed that serum LDL-C，hs-CRP，and carotid ultrasound parameters were significantly correlated with coronary heart disease（P < 0.05）. （4） ROC curve analysis demonstrated that the combined assessment of serum LDL-C， hs-CRP， and carotid ultrasound parameters achieved the highest area under the curve （AUC）， sensitivity， and specificity， with statistically significant differences compared to individual markers（P < 0.05）. Conclusions Serum LDL-C，hs-CRP，and carotid ultrasound parameters individually have predictive value for coronary heart disease， while their combined assessment offers superior predictive accuracy. The enhanced diagnostic performance of the combined valuation provides valuable guidance for the diagnosis and management of patients with suspected coronary heart disease.