Background: To compare the predictive power of flow-mediated dilation (FMD), brachial-ankle pulse wave velocity (baPWV), and age-adjusted Framingham risk score (AFRS) for the prediction of the significant coronary heart disease (CHD) in the patients with suspected angina. Methods: In 138 patients with chest pain that were scheduled to undergo coronary angiography (CAG) prospectively enrolled the study. The interrelationship between AFRS and FMD with baPWV was analyzed by least squares linear regression. Multivariate logistic regression analysis was performed to assess independent predictors of significant CHD. The power of independent predictors for the detection of significant CHD was compared by receiver operating characteristic (ROC) analysis. Results: Seventy-one patients had significant CHD on CAG. The FMD showed significant inverse correlation with AFRS (r=-0.43, p<0.01) and the baPWV was significantly correlated with AFRS (r=0.41, p<0.01). The independent predictors for significant CHD were AFRS and FMD (odds ratio [OR] 20.098, 95% confidence interval [CI] 4.773-84.627, p<0.01, and OR 0.865, 95% CI 0.752-0.995, p<0.05, respectively). The area under the ROC curves for detecting significant CHD, AFRS, inverse FMD value, and baPWV were 0.863 (95% CI 0.800-0.927, p<0.01), 0.726 (95% CI 0.643-0.809, p<0.01), and 0.694 (95% CI 0.605-0.784, p<0.01). In addition, the overall performance of AFRS was more powerful than that of inverse FMD value and baPWV (z=2.982, p<0.01 and z=3.485, p<0.01, respectively). Conclusion: AFRS and FMD were independent predictors of significant CHD in patients with suspected angina. In addition, AFRS was a more powerful predictor of significant CHD than was inverse FMD value and baPWV.