Objective To explore the predictive value of combined detection of fibrinogen (D-dimer) and serum lipoprotein a (Lp (a)) in diabetes patients with coronary artery disease. Methods The D-dimer and Lp (a) levels in 67 cases of diabetic patients with coronary heart disease, 57 cases of patients with diabetes alone and 76 cases of healthy controls were detected. Results The D-dimer and Lp (a) levels in diabetic patients with coronary heart disease group were significantly higher than those in the diabetic group and the healthy controls (P<0.05), and the D-dimer and Lp (a) levels in diabetic group were also significantly higher than that of in healthy controls (P <0.05). Conclusion The combined detection of D-dimer and Lp (a)) is conducive to early diagnosis of coronary heart disease caused by diabetes, and delaying the progress of coronary heart disease.