This study aimed to explore the association between seven novel and easily accessible insulin resistance (IR) surrogates and incident coronary heart disease (CHD) in a Chinese population, and to compare their predictive powers. The study included 6393 participants without cardiovascular disease (CVD) at baseline, followed for a median of 10.25 years. Cox regression analyses and receiver operating characteristic (ROC) curves were used to evaluate the association and predictive values of the IR surrogates. The results showed that all seven IR surrogates (except VAI) were significantly associated with incident CHD after adjustment, with CVAI showing the strongest predictive capacity among them. The CVAI had the highest area under the ROC curve (AUC) of 0.632, significantly higher than other IR surrogates. The study concluded that all seven IR surrogates are positively associated with incident CHD in Chinese populations, and CVAI may be the best marker for predicting CHD development. Additionally, TyG-related indexes outperformed the TyG index in predicting CHD incidence.This study aimed to explore the association between seven novel and easily accessible insulin resistance (IR) surrogates and incident coronary heart disease (CHD) in a Chinese population, and to compare their predictive powers. The study included 6393 participants without cardiovascular disease (CVD) at baseline, followed for a median of 10.25 years. Cox regression analyses and receiver operating characteristic (ROC) curves were used to evaluate the association and predictive values of the IR surrogates. The results showed that all seven IR surrogates (except VAI) were significantly associated with incident CHD after adjustment, with CVAI showing the strongest predictive capacity among them. The CVAI had the highest area under the ROC curve (AUC) of 0.632, significantly higher than other IR surrogates. The study concluded that all seven IR surrogates are positively associated with incident CHD in Chinese populations, and CVAI may be the best marker for predicting CHD development. Additionally, TyG-related indexes outperformed the TyG index in predicting CHD incidence.