Objective The thrombospondin-4 (TSP-4) gene G29926C (A387P) polymorphism was recently reported to be associated with an increased risk for MI (myocardial infarction) in the American population. However, several subsequent studies produced controversial findings. The aim of this study was to explore the possible association of the TSP-4 A387P polymorphism with ACS (acute coronary syndrome) in a Chinese Han population. Methods A case-control study including 412 patients with ACS and 337 controls free from CAD (coronary artery disease) was conducted. The TSP-4 A387P polymorphism was determined by PCR (polymerase chain reaction) and RFLP (restriction fragment length polymorphism) analysis. Results Slightly decreased frequency of GC genotype was observed in patients with ACS, compared with controls (5.3% vs 7.1%), but the difference did not reach statistical significance (P = 0.31). Similarly, the prevalences of the C allele were 2/7% and 3.6% for ACS and control groups, respectively (P = 0.32). None of the homozygotes was detected for the C allele. Further analyses in subjects subgrouped according to sex and age also showed no association of TSP-4 A387P polymorphism with ACS. Furthermore, after adjustment for conventional risk factors by multiple logistic regression analysis, the carrier prevalence of the C allele did not differ significantly between the ACS and control groups (OR = 0.85; 95% CI: 0.45-1.59; P = 0.60).ConclU8lon The present study suggested that the TSP-4 A387P variant show a low prevalence compared with western populations and fail to associate with an altered risk of ACS in the Chinese Han population. The findings further supplement experimental data for TSP-4 gene study of the coronary disease. Objective The thrombospondin-4 (TSP-4) gene G29926C (A387P) polymorphism was recently reported to be associated with an increased risk for MI (myocardial infarction) in the American population. However, several subsequent studies produced controversial findings. The aim of this study was to explore the possible association of the TSP-4 A387P polymorphism with ACS (acute coronary syndrome) in a Chinese Han population. Methods A case-control study including 412 patients with ACS and 337 controls free from CAD (coronary artery disease) was Results Slightly decreased frequency of GC genotype was observed in patients with ACS, compared with controls (5.3% vs 7.1%). The TSP-4 A387P polymorphism was determined by PCR (polymerase chain reaction) and RFLP (restriction fragment length polymorphism) ), but the difference did not reach statistical significance (P = 0.31). Similarly, the prevalences of the C allele were 2/7% and 3.6% for ACS and control groups, respectively (P = 0 .32). None of the homozygotes was detected for the C allele. Further analyzes in subjects subgrouped according to sex and age also showed no association of TSP-4 A387P polymorphism with ACS. Further, after adjustment for conventional risk factors by multiple logistic regression analysis, the carrier prevalence of the C allele did not differ significantly between the ACS and control groups (OR = 0.85; 95% CI: 0.45-1.59; P = 0.60) .ConclU8lon The present study suggested that the TSP-4 A387P variant show a low prevalence compared with western populations and fail to associate with an altered risk of ACS in the Chinese Han population. The findings further supplement experimental data for TSP-4 gene study of the coronary disease.