Abstract:Objective To investigate the risk factors of coronary atherosclerotic heart disease（CHD）complicated with atrial fibrillation（AF）and its correlation with remnant cholesterol（RC）. Methods A retrospective analysis was conducted on 816 patients diagnosed with CHD in the Cardiovascular Department of Xuzhou Central Hospital from October 2022 to October 2023. By reviewing the case data from the hospital information system，the patients were divided into CHD with AF group（n=144）and CHD without AF group（n=672）according to whether they had AF in the past and during hospitalization. Baseline data，total cholesterol（TC），low-density lipoprotein cholesterol（LDL-C），high-density lipoprotein cholesterol（HDL-C），and RC levels，personal history，and past medical history of CHD patients were compared between the two groups. Logistic regression analysis was used to explore the influencing factors affecting CHD patients with AF. Receiver operating characteristic（ROC）curve was used to analyze the value of RC for CHD patients with AF. Results The RC level in the CHD with AF group was lower than that in the CHD without AF group［0.30（- 0.28，0.55）mmol/L vs 0.57（0.28，0.97）mmol/L］，with statistically significant difference（Z=7.929，P<0.01）.Logistic regression analysis showed that increased RC was a protective factor for AF occurrence in CHD patients（OR=0.30，P<0.05），RC was negatively correlated with the severity of symptoms in AF patients（r=- 0.290，P<0.05）. Conclusion Low RC level is a risk factor for CHD patients with AF，and RC has certain predictive value for CHD patients with AF and the severity of AF symptoms.