Objective To investigate myocardial injury following open surgery(OS) for abdominal aortic aneurysm compared with endovascular repair(EVR).Methods The clinical data of 142 patients with abdominal aortic aneurysm treated by open surgery (n=75) and endovascular repair (n=67) were analyzed.All patients were divided into three groups according to the results of Coronary CTA.The patients with Coronary CTA displaying at least one stenosis ≥75% were divided into the group of severe stenosis, the ones with at least one stenosis ≥50% were moderate, and those with stenosis < 50% were mild.The clinical data and post-operative elevated cTnI (≥0.01ng/ml) rate were compared between OS and EVR in every group.Results In the group of moderate stenosis, elevated cTnI was found in 6 of the 13 patients treated by EVR(46%) and in 13 of the 15 patients treated by OS.There was statistically significant difference between two surgeries(P=0.042),but there was no statistically significant difference in the groups of severe or mild stenosis.Conclusion Myocardial injury rate after EVR is lower than that after OS in the patients with moderate stenosis.