Abstract: AIM To quantitatively examine plasma mtTFA content of patients with coronary atherosclerosis heart disease (CAHD) and to evaluate its application as a risk predictor for CAHD. MEHTODS Blood samples were collected from 187 CAHD patients, including 94 cases with stable angina pectoris (SAP), 56 with unstable angina pectoris (UAP) and 37 with acute myocardial infarction (AMI), and 190 healthy controls. Plasma mtTFA content in each group was detected by enzyme-linked immunosorbent assay. The clinical association of plasma mtTFA content with CAHD was analyzed and receiver operating characteristic (ROC) curve was performed to predict the risk of CAHD by plasma mtTFA content. RESULTS CAHD patients exhibited statistically significantly higher plasma mtTFA content (median:AMI, 3.17 μg/L; UAP, 2.32 μg/L; SAP, 1.92 μg/L) than matched controls (median:1.79 μg/L; P<0.01). Plasma mtTFA content was positively associated with TG (P=0.018), LDL-C (P=0.015) and AIP (P=0.009).Compared with individuals with lower mtTFA content, individuals with higher mtTFA content had a significantly increased risk of CAHD (adjusted OR,2.84; 95%CI,1.21-3.96) when healthy controls were used as the reference group. A significant dose-response relation was observed between CAHD risk and higher mtTFA content (P for trend <0.001). In addition, area under the ROC curve performed by the plasma mtTFA from all participants was 0.790 (95%CI: 0.721-0.849). With a cutoff value of 2.26 μg/L, overall sensitivity was 72.2% and specificity was 79.2%. CONCLUSION Plasma mtTFA content is positively related to the risk of CAHD. Plasma mtTFA content could be used to monitor the occurrence of CAHD and may be a potential marker for early diagnosis of CAHD.