Objective：This study aims to explore the relationship between the oxidative stress-lipid metabolism composite biomarker Hpx·apoB[the product of hemopexin（Hpx）and apolipoprotein B（apoB）]and coronary artery disease（CAD），and evaluate its value in clinical risk stratification. Methods：The study utilized liquid chromatography-tandem mass spectrometry to quantify plasma Hpx levels in 107 CAD patients and 33 controls without CAD，collected the clinical data，and constructed a multivariate logistic regression model to analyze the association strength between Hpx ·apoB and CAD. The predictive efficacy of the model was evaluated by area under the receiver operating characteristic（ROC）curve（AUC）and net reclassification index（NRI）. Results：The Hpx·apoB value in the CAD group was significantly higher than that in the control group（P ＜ 0.01）. The Hpx·apoB value was significantly increased in patients with acute myocardial infarction，acute coronary syndrome，and multi - vessel coronary artery disease（all P ＜ 0.01）. Multivariate logistic regression analysis showed that Hpx·apoB was an independent risk factor for CAD（OR=2.554，95%CI：1.336-4.881，P ＜ 0.01）. The ROC curve showed that its AUC for predicting CAD was 0.667，and the predictive efficacy was significantly improved when combined with C-reactive protein（CRP）+low-density lipoprotein cholesterol（LDL-C）：ΔAUC=0.106（P ＜ 0.05），NRI=15.6%（P ＜ 0.05）. After integration with the clinical risk model，it showed a higher predictive value，when integrated with Framingham score：ΔAUC=0.076（P= 0.139），NRI=27.0%（P ＜ 0.01）；when integrated with SCORE model：ΔAUC=0.142（P=0.093），NRI=37.55%（P ＜ 0.001）. Further subgroup analysis revealed that Hpx·apoB has a stronger predictive ability for CAD in men, smokers，and patients with impaired renal function（P ＜ 0.05）. Conclusion：Hpx · apoB，as a composite indicator of oxidative stress and lipid metabolism，can independently predict the risk of CAD. When combined with the clinical risk score，it significantly improves the risk prediction efficacy.