To investigate the relationship between age and coronary artery remodeling in patients with acute coronary syndrome (ACS), 56 patients with ACS were identified by intravascular ultrasound (IVUS). Remodeling index (RI) (37 cases of RI > or =1 vs 19 cases of RI <1) and dimidiate age groups (27 patients younger than 60 years vs 29 patients 60 years or older) were compared, and the relationships among biomarkers, age, and arterial remodeling were analyzed. There was a significant difference in age between positive and negative remodeling groups (55+/-13 vs 62+/-10 years; P=.038); RI and triglyceride level showed a statistical correlation (r=0.32; P=.02) and a significant inverse correlation between age and RI (r=-0.47; P<.001). The multivariable linear regression analysis demonstrated that age was an independent predictor of RI (Bate -0.37; 95% confidence interval, 0.93-1.08; P=.04). Age may be an important factor of arterial remodeling. Low-density lipoprotein or triglyceride level may be associated with attenuated coronary vascular remodeling with aging.